Provider Demographics
NPI:1063538700
Name:SHOAEE, ALI (DDS)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:SHOAEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 DAIRY ASHFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4602
Mailing Address - Country:US
Mailing Address - Phone:832-230-5222
Mailing Address - Fax:832-200-3161
Practice Address - Street 1:1013 DAIRY ASHFORD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4602
Practice Address - Country:US
Practice Address - Phone:832-230-5222
Practice Address - Fax:832-200-3161
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22119122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist