Active NPI
Ayesha Fatima Ali, DMD
- Student in an Organized Health Care Education/Training Program
- Bronx, NY
National Provider Identifier
1023747565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 063623
- Practice address
- 111 E 210TH St
Bronx, NY 10467-2401 - Phone
- (718) 920-4321
- NPI assigned
- Jun 9, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | 063623 | NY | Primary |
| General Practice Dentistry | 1223G0001X | 063623 | NY |
Addresses
Primary practice location
111 E 210TH St
Bronx, NY 10467-2401
Mailing address
297 Haverstraw Rd
Montebello, NY 10901-3431
Phone (845) 536-2070
Other practice location 1
335 Broadway
Long Branch, NJ 07740-6901
Phone (732) 451-4030
Other practice location 2
75 Dolson Ave
Middletown, NY 10940-6501
Phone (845) 208-5063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 063623 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719705600000",
"number": "1023747565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "297 HAVERSTRAW RD",
"city": "MONTEBELLO",
"state": "NY",
"postal_code": "109013431",
"telephone_number": "845-536-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-4321"
}
],
"practiceLocations": [
{
"address_1": "335 Broadway",
"address_purpose": "LOCATION",
"city": "Long Branch",
"state": "NJ",
"postal_code": "077406901",
"country_code": "US",
"telephone_number": "732-451-4030",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "75 Dolson Ave",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "NY",
"postal_code": "109406501",
"country_code": "US",
"telephone_number": "845-208-5063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALI",
"first_name": "AYESHA",
"middle_name": "FATIMA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-09",
"last_updated": "2024-06-30",
"certification_date": "2024-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "063623",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "063623",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.