Provider Demographics
NPI:1790718187
Name:SHIRANI, ALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:SHIRANI
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 1:3725 LONE TREE WAY # F
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6064
Mailing Address - Country:US
Mailing Address - Phone:925-778-1998
Mailing Address - Fax:
Practice Address - Street 1:3725 LONE TREE WAY # F
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6064
Practice Address - Country:US
Practice Address - Phone:925-778-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice