Botros Gamal Aiyad, DDS
Individual provider Active NPI Dentist · Cookeville, TN
NPI 1720697444 · NPPES record last updated Jul 28, 2020
Key facts
- NPI
- 1720697444
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 11379 (TN)
- Practice address
- 220 N Washington Ave
Cookeville, TN 38501-2642 - Phone
- (615) 554-6019
- NPI assigned
- Jul 28, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11379 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Care at Stones River | Current | Accepting new patients | |
| Hendersonville Smiles | Dentist | Current | Accepting new patients |
| Healthplex PLLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11379 | TN | Yes |
Addresses
Primary practice location
220 N Washington Ave
Cookeville, TN 38501-2642
Mailing address
901 Crownhill Dr
Nashville, TN 37217-1403
Phone (615) 554-6019
Other practice location 1
901 Crownhill Dr
Nashville, TN 37217-1403
Phone (615) 554-6019
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Bgadental@gmail.com |
Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.