Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 MERCHANTS ROW STE 104
WILLISTON VT
05495-4476
US

IV. Provider business mailing address

5 JANNELL CT
EPPING NH
03042-2219
US

V. Phone/Fax

Practice location:
  • Phone: 802-497-6310
  • Fax:
Mailing address:
  • Phone: 603-691-2895
  • 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 NumberDEN5420
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDL100372
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number016.0134311
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: