MEDICARE: ALYA ELSAYED-ALI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401415250	VA

General Provider Information

NPI Number	:	1730531492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYA ELSAYED-ALI DDS

Provider Business Mailing Address
First Line	:	4009 MAIN ST
Second Line	:
City	:	CHINCOTEAGUE
State	:	VA
Zip	:	23336
Country	:	US
Telephone Number	:	757-336-2160
Fax Number	:

Provider Business Practice Location Address
First Line	:	4009 MAIN ST
Second Line	:
City	:	CHINCOTEAGUE
State	:	VA
Zip	:	23336-2406
Country	:	US
Telephone Number	:	757-336-1260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	05/17/2017

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