Provider Demographics
NPI:1376960583
Name:ALI, A. SHERRIFF FAROUK (DDS)
Entity Type:Individual
Prefix:DR
First Name:A. SHERRIFF
Middle Name:FAROUK
Last Name:ALI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:AHMAD SHERRIFF
Other - Middle Name:FAROUK
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9936 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5700
Mailing Address - Country:US
Mailing Address - Phone:202-492-5801
Mailing Address - Fax:
Practice Address - Street 1:1406 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4553
Practice Address - Country:US
Practice Address - Phone:352-686-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN218311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice