Provider Demographics
NPI:1194871426
Name:AYALA, ANA EVELYN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:EVELYN
Last Name:AYALA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-0209
Mailing Address - Country:US
Mailing Address - Phone:787-738-9350
Mailing Address - Fax:787-738-9350
Practice Address - Street 1:200 CARR 7733
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3394
Practice Address - Country:US
Practice Address - Phone:787-739-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22901223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4204AYMedicare UPIN
PR9260210Medicare UPIN