Provider Demographics
NPI:1134016587
Name:GHASSAN JAYYAR DDS PC
Entity type:Organization
Organization Name:GHASSAN JAYYAR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHASSAN
Authorized Official - Middle Name:ADNAN
Authorized Official - Last Name:JAYYAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-383-4645
Mailing Address - Street 1:13465 CAMINO CANADA STE 110A
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-8814
Mailing Address - Country:US
Mailing Address - Phone:619-383-4645
Mailing Address - Fax:
Practice Address - Street 1:13465 CAMINO CANADA STE 110A
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-8814
Practice Address - Country:US
Practice Address - Phone:619-390-3669
Practice Address - Fax:619-390-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty