Provider Demographics
NPI:1194456046
Name:ALI, SUNBL IHSAN (DDS)
Entity type:Individual
Prefix:
First Name:SUNBL
Middle Name:IHSAN
Last Name:ALI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 N FOREST RD APT D4
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3255
Mailing Address - Country:US
Mailing Address - Phone:174-202-7658
Mailing Address - Fax:
Practice Address - Street 1:4898 LITTLE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1054
Practice Address - Country:US
Practice Address - Phone:817-420-2765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist