Ali Abdallah, BDS, CAGS, DSCD, FAC
Individual provider Active NPI Prosthodontics · Boston, MA
NPI 1104499466 · NPPES record last updated Apr 18, 2024
Key facts
- NPI
- 1104499466
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthodontics 1223P0700X
- License
- DF12020 (MA)
- Practice address
- 930 Commonwealth Ave
Boston, MA 02215-1274 - Phone
- (617) 358-1000
- NPI assigned
- Jul 22, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DF12020 | MA | MD | Prosthodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DF12020 | MA | Yes |
Addresses
Primary practice location
930 Commonwealth Ave
Boston, MA 02215-1274
Mailing address
100 E Newton St # G203
Boston, MA 02118-3552
Phone (617) 283-3041
Other providers in Boston, MA
- Ashraf Abd-Elmeguid
- Alejandro Abdala
- Mohamad K Abdalkader
- Gracie Anne Abdalla
- Moustafa Abdalla
- Bassima J Abdallah
- Maya M Abdallah
- Rima Abdallah
- Shadi Abdar Esfahani
- Ayesha Abdeen
All providers in Boston, MA · Prosthodontics in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.