Provider Demographics
NPI:1073352829
Name:MIFALANI, ALADDIN
Entity type:Individual
Prefix:
First Name:ALADDIN
Middle Name:
Last Name:MIFALANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 PEBBLEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-4565
Mailing Address - Country:US
Mailing Address - Phone:440-497-8025
Mailing Address - Fax:
Practice Address - Street 1:5716 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1715
Practice Address - Country:US
Practice Address - Phone:216-415-5504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027552122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist