Provider Demographics
NPI:1750365383
Name:HAYAT ALI DDS INC
Entity type:Organization
Organization Name:HAYAT ALI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-476-9930
Mailing Address - Street 1:11501 LORAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5402
Mailing Address - Country:US
Mailing Address - Phone:164-769-9302
Mailing Address - Fax:164-769-9322
Practice Address - Street 1:11501 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5402
Practice Address - Country:US
Practice Address - Phone:164-769-9302
Practice Address - Fax:216-476-9932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2003790Medicaid
OH0004410OtherDORAL
OH2003790Medicaid