Healthcare Provider Details

I. General information

NPI: 1093378192
Provider Name (Legal Business Name): AYZA MAHMOOD DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8680 FENTON STREET
ORLANDO FL
32836
US

IV. Provider business mailing address

8680 FENTON STREET
ORLANDO FL
32836
US

V. Phone/Fax

Practice location:
  • Phone: 586-668-1236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN23895
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number23895
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: