Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DEN.00203228 | CO |
Y | 213EG0000X | General Practice | DEN.00203228 | CO |
N | 1223P0300X | Periodontist | 36105 | TX |
NPI | 1124546809 |
---|---|
Provider Name | Omar Al Bayati |
First Address | Denver, CO 80238-3626 |
Second Address | Denver, CO 80206-5316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2017 |
Last Update Date | 01/07/2020 |