Provider Demographics
NPI:1245342815
Name:AKBERALI, ALIAKBER F (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:ALIAKBER
Middle Name:F
Last Name:AKBERALI
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-3820
Mailing Address - Country:US
Mailing Address - Phone:918-588-1900
Mailing Address - Fax:918-582-6405
Practice Address - Street 1:550 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-3820
Practice Address - Country:US
Practice Address - Phone:918-588-1900
Practice Address - Fax:918-582-6405
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100188820AMedicaid
OK73-1042545OtherGROUP MEDICARE
OK73-1042545OtherGROUP COMMUNITY CARE OF OKLAHOMA
OK73-1042545OtherGROUP BCBS
OK100732910-GOtherGROUP MEDICAID/SOONERCARE
OK100732910-AOtherGROUP MEDICAID/SOONERCARE
OK731042545001OtherGROUP TRICARE