Provider Demographics
NPI:1174293443
Name:SKOOTI, ALI L (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:L
Last Name:SKOOTI
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 1:8089 S LINCOLN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2719
Mailing Address - Country:US
Mailing Address - Phone:303-794-9271
Mailing Address - Fax:
Practice Address - Street 1:8089 S LINCOLN ST STE 102
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2719
Practice Address - Country:US
Practice Address - Phone:303-794-9271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00205011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist