Healthcare Provider Details

I. General information

NPI: 1609547348
Provider Name (Legal Business Name): NILAY AYAZ BDS, CAGS, MSD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MILL ST
LEOMINSTER MA
01453-3592
US

IV. Provider business mailing address

326 NICHOLS RD
FITCHBURG MA
01420-1914
US

V. Phone/Fax

Practice location:
  • Phone: 978-878-8100
  • Fax:
Mailing address:
  • Phone: 978-878-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number05278
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDL100372
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number016.0134311
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: