Mohamad Bashar Ayass, DMD
Individual provider Active NPI General Practice Dentistry · Centreville, VA
NPI 1730465154 · NPPES record last updated Oct 31, 2011
Key facts
- NPI
- 1730465154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401411737 (VA)
- Practice address
- 14631 Lee Hwy
#301
Centreville, VA 20121 - Phone
- (703) 830-2256
- NPI assigned
- Oct 31, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 0401411737 | VA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401411737 | VA | Yes |
Addresses
Primary practice location
14631 Lee Hwy
#301
Centreville, VA 20121
Mailing address
14631 Lee Hwy
#301
Centreville, VA 20121-5824
Phone (703) 830-2256
Other providers in Centreville, VA
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- Jose I Aunon
- Aura Home Care, LLC
- Autism Therapy, LLC
- Elizabeth Gilhooley Ayrovainen
- Robert Aziz
- Christine Tawfik Azmy
- Back2Good Chiropractics
- Kristen H Bae
All providers in Centreville, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2011. 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.