Provider Demographics
NPI:1790902070
Name:ALI H. NIA, D.M.D., P.C.
Entity Type:Organization
Organization Name:ALI H. NIA, D.M.D., P.C.
Other - Org Name:MESA DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:H
Authorized Official - Last Name:NIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-730-0500
Mailing Address - Street 1:1930 S DOBSON RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5657
Mailing Address - Country:US
Mailing Address - Phone:480-730-0500
Mailing Address - Fax:480-730-0525
Practice Address - Street 1:1930 S DOBSON RD
Practice Address - Street 2:SUITE #1
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5657
Practice Address - Country:US
Practice Address - Phone:480-730-0500
Practice Address - Fax:480-730-0525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty