Provider Demographics
NPI:1922860550
Name:ALI, KAHKSHAN ASHRAF (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAHKSHAN
Middle Name:ASHRAF
Last Name:ALI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4281 EXPRESS LN STE N5613
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34249-2602
Mailing Address - Country:US
Mailing Address - Phone:804-381-6616
Mailing Address - Fax:
Practice Address - Street 1:KING FAISAL SPECIALIST HOSPITAL
Practice Address - Street 2:MBC #70
Practice Address - City:RIYADH
Practice Address - State:RIYADH
Practice Address - Zip Code:11211
Practice Address - Country:SA
Practice Address - Phone:804-381-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice