Provider Demographics
NPI:1235868217
Name:AFRIDI, HAJIRAH ALI (DMD)
Entity Type:Individual
Prefix:
First Name:HAJIRAH
Middle Name:ALI
Last Name:AFRIDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 HANCOCK ST APT 314
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4352
Mailing Address - Country:US
Mailing Address - Phone:617-606-0933
Mailing Address - Fax:
Practice Address - Street 1:70 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1811
Practice Address - Country:US
Practice Address - Phone:508-588-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
MADN1859479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program