Healthcare Provider Details

I. General information

NPI: 1902973449
Provider Name (Legal Business Name): EYAD MAYANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EYAD ALMAHAYNI DMD

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2098 COMMONWEALTH AVE
AUBURNDALE MA
02466-1911
US

IV. Provider business mailing address

1 INTERNATIONAL PL
BOSTON MA
02110-2602
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-3700
  • Fax: 617-964-3710
Mailing address:
  • Phone: 617-330-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number19583
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: