Provider Demographics
NPI:1114295771
Name:ALI, FERDOUS AHMED (DMD)
Entity Type:Individual
Prefix:
First Name:FERDOUS
Middle Name:AHMED
Last Name:ALI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2423
Mailing Address - Country:US
Mailing Address - Phone:321-288-2507
Mailing Address - Fax:
Practice Address - Street 1:2 CAMBRIDGE LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3325
Practice Address - Country:US
Practice Address - Phone:267-417-8271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413810122300000X
NY0576291223E0200X
NJ22DI026115001223E0200X
FLDN196631223E0200X
PADS0418231223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist