Healthcare Provider Details

I. General information

NPI: 1720846504
Provider Name (Legal Business Name): AYE MYAT DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 CHERRY ST
MILFORD CT
06460
US

IV. Provider business mailing address

203 CHERRY ST
MILFORD CT
06460-3501
US

V. Phone/Fax

Practice location:
  • Phone: 203-874-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2.014324
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.035080
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: