Provider Demographics
NPI:1710093224
Name:FAIZ, ALI ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:ALLEN
Last Name:FAIZ
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 1:1311 W CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2815
Mailing Address - Country:US
Mailing Address - Phone:972-231-3188
Mailing Address - Fax:972-231-3148
Practice Address - Street 1:1311 W CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2815
Practice Address - Country:US
Practice Address - Phone:972-231-3188
Practice Address - Fax:972-231-3148
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX185061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
60095392OtherDPS
60095392OtherDPS