Provider Demographics
NPI:1720650203
Name:NILI, ALI (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:NILI
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 N FRANKLIN DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5874
Mailing Address - Country:US
Mailing Address - Phone:724-223-0579
Mailing Address - Fax:
Practice Address - Street 1:2112 N FRANKLIN DR STE 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5874
Practice Address - Country:US
Practice Address - Phone:724-223-0579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS045013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist