Provider Demographics
NPI:1285083451
Name:RAD, ALI (DMD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:RAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:ABDUL MAJEED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 WHALON ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7162
Mailing Address - Country:US
Mailing Address - Phone:978-345-6911
Mailing Address - Fax:
Practice Address - Street 1:100 WHALON ST STE 1A
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7162
Practice Address - Country:US
Practice Address - Phone:978-345-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18583611223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics