Provider Demographics
NPI:1265635585
Name:SAMI, ALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:SAMI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:SAMI-KERMANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9331 MISSION GORGE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-3883
Mailing Address - Country:US
Mailing Address - Phone:619-448-2158
Mailing Address - Fax:619-448-2165
Practice Address - Street 1:9331 MISSION GORGE RD STE 105
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3883
Practice Address - Country:US
Practice Address - Phone:619-448-2158
Practice Address - Fax:619-448-2165
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557461223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery