Healthcare Provider Details

I. General information

NPI: 1508790759
Provider Name (Legal Business Name): ALIYAH HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 OVER LAKE DR SE
CONYERS GA
30013-1777
US

IV. Provider business mailing address

1807 OVER LAKE DR SE
CONYERS GA
30013-1777
US

V. Phone/Fax

Practice location:
  • Phone: 770-922-3131
  • Fax:
Mailing address:
  • Phone: 770-922-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124177
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: