Healthcare Provider Details

I. General information

NPI: 1689590374
Provider Name (Legal Business Name): JOSEPH-AYAD LAYTH KACHACHI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13003 ROACHTON RD
PERRYSBURG OH
43551-1357
US

IV. Provider business mailing address

49657 WHITEHALL
SHELBY TOWNSHIP MI
48317-6329
US

V. Phone/Fax

Practice location:
  • Phone: 419-874-7071
  • Fax:
Mailing address:
  • Phone: 586-522-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028578
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.028578
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: