Provider Demographics
NPI:1720650203
Name:NILI, ALI (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:NILI
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2897 W HIGHWAY 74
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-8434
Mailing Address - Country:US
Mailing Address - Phone:704-225-9823
Mailing Address - Fax:
Practice Address - Street 1:2897 W HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8434
Practice Address - Country:US
Practice Address - Phone:704-225-9823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice