Provider Demographics
NPI:1316469844
Name:ALDABE, ALI MAHMOUD (DMD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:MAHMOUD
Last Name:ALDABE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5189 CLAIREMONT MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-1446
Mailing Address - Country:US
Mailing Address - Phone:858-277-4764
Mailing Address - Fax:858-505-0647
Practice Address - Street 1:5189 CLAIREMONT MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-1446
Practice Address - Country:US
Practice Address - Phone:708-979-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101575122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist