Provider Demographics
NPI:1144743451
Name:ALI, SHAFINAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAFINAZ
Middle Name:
Last Name:ALI
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 1:4211 BRITTHILL LN
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8146
Mailing Address - Country:US
Mailing Address - Phone:770-309-9133
Mailing Address - Fax:
Practice Address - Street 1:1504 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2237
Practice Address - Country:US
Practice Address - Phone:919-735-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10701122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist