Provider Demographics
NPI:1992232896
Name:AL-ANI, ASEEL A (DDS)
Entity type:Individual
Prefix:
First Name:ASEEL
Middle Name:A
Last Name:AL-ANI
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 1:2655 RIDGEWAY AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4296
Mailing Address - Country:US
Mailing Address - Phone:585-295-1890
Mailing Address - Fax:585-295-1898
Practice Address - Street 1:2655 RIDGEWAY AVE STE 360
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-295-1890
Practice Address - Fax:585-295-1898
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0622431223G0001X
OH30.0262141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty