Provider Demographics
NPI:1588711568
Name:ALI, NEHAL (DDS)
Entity type:Individual
Prefix:DR
First Name:NEHAL
Middle Name:
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 1:2323 NE 26TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1147
Mailing Address - Country:US
Mailing Address - Phone:754-238-1038
Mailing Address - Fax:754-238-1030
Practice Address - Street 1:2323 NE 26TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:754-238-1038
Practice Address - Fax:754-283-1038
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00D181 1800OtherBCBS PIN NUMBER
MI000 000 301 167OtherUNITED HEALTH CARE ID
MI4910434Medicaid