Provider Demographics
NPI:1588341028
Name:DALAL, AYUSHI (DDS)
Entity type:Individual
Prefix:DR
First Name:AYUSHI
Middle Name:
Last Name:DALAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 WALBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-4029
Mailing Address - Country:US
Mailing Address - Phone:832-600-9024
Mailing Address - Fax:
Practice Address - Street 1:9315 SPENCER HWY STE B
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-3968
Practice Address - Country:US
Practice Address - Phone:281-394-1782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX394821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice