Individual provider Active NPI

Sirrene Seaeda Ayyad, DMD

  • General Practice Dentistry
  • Goodyear, AZ
National Provider Identifier
1508750050
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D012520 Issued in AZ
Practice address
18593 W Larkspur Dr
Goodyear, AZ 85338-7481
Phone
(760) 215-4228
NPI assigned
Jun 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D012520 AZ Primary

Addresses

Primary practice location

18593 W Larkspur Dr
Goodyear, AZ 85338-7481

Mailing address

18593 W Larkspur Dr
Goodyear, AZ 85338-7481
Phone (760) 215-4228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251205004388 AZ Practitioner - Dentist 5698268795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3003 N Central Ave
Suite 1600
Phoenix, AZ 85012-2908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D012520AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center CurrentSince Nov 17, 2025 Accepting new patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Nov 17, 2025 Accepting new patients

Locations

635 E Baseline Rd
Phoenix, AZ 85042

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1508750050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18593 W LARKSPUR DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853387481",
            "telephone_number": "760-215-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18593 W LARKSPUR DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853387481",
            "telephone_number": "760-215-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYYAD",
        "first_name": "SIRRENE",
        "middle_name": "SEAEDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.