Provider Demographics
NPI:1942092457
Name:FAY, ALYSSA (DDS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:FAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3184 VT ROUTE 105
Mailing Address - Street 2:
Mailing Address - City:WEST CHARLESTON
Mailing Address - State:VT
Mailing Address - Zip Code:05872-9705
Mailing Address - Country:US
Mailing Address - Phone:508-498-4399
Mailing Address - Fax:
Practice Address - Street 1:494 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-4919
Practice Address - Country:US
Practice Address - Phone:802-334-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.0134361122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist