Provider Demographics
NPI:1477828721
Name:ARASTU, ALI MAHIN (DMD)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:MAHIN
Last Name:ARASTU
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 1:1420 LOCUST ST
Mailing Address - Street 2:APT 30P
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4223
Mailing Address - Country:US
Mailing Address - Phone:210-557-9771
Mailing Address - Fax:215-646-6166
Practice Address - Street 1:401 COMMERCE DR
Practice Address - Street 2:SUITE 108
Practice Address - City:FT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2714
Practice Address - Country:US
Practice Address - Phone:215-550-7186
Practice Address - Fax:215-646-6166
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX274101223G0001X
PADS0401461223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice