Provider Demographics
NPI:1508958794
Name:ALI, SAMIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMIA
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 1:11411 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5026
Mailing Address - Country:US
Mailing Address - Phone:314-941-8029
Mailing Address - Fax:
Practice Address - Street 1:11411 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5026
Practice Address - Country:US
Practice Address - Phone:314-941-8029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA54569OtherCA DENTAL LICENCE #