Provider Demographics
NPI:1407364458
Name:ALI, FARAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARAH
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 1:350 VILLAGE DR UNIT 1410
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2096
Mailing Address - Country:US
Mailing Address - Phone:848-667-0293
Mailing Address - Fax:
Practice Address - Street 1:235 S POTTSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2747
Practice Address - Country:US
Practice Address - Phone:610-363-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL13670122300000X
PADS041582122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist