Provider Demographics
NPI:1609964147
Name:BIPAR, ALI AKBAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:AKBAR
Last Name:BIPAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4232 E CACTUS RD
Mailing Address - Street 2:SUITE #107
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7602
Mailing Address - Country:US
Mailing Address - Phone:602-494-1448
Mailing Address - Fax:602-494-4766
Practice Address - Street 1:4611 E SHEA BLVD STE 107
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4254
Practice Address - Country:US
Practice Address - Phone:602-494-1448
Practice Address - Fax:602-494-4766
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46531223P0300X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0300XDental ProvidersDentistPeriodontics