Mohamed Mukhtar Ali, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13977 Issued in MN

Practice address

4700 Cedar Ave S
Minneapolis, MN 55407

Phone

(240) 765-4938

NPI assigned

May 12, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeshore Dental

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1356801799
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1154811404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8680 MARIGOLD CIR APT 307",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447641",
            "telephone_number": "240-765-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "240-765-4938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "964 Lynn Rd SW",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "MN",
            "postal_code": "553503151",
            "country_code": "US",
            "telephone_number": "320-228-6538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "964 Lynn Rd SW",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "MN",
            "postal_code": "553503151",
            "country_code": "US",
            "telephone_number": "320-228-6538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "MOHAMED",
        "middle_name": "MUKHTAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-12",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malyun Mohamed Ali
• Maryam Abdulahi Ali
• Maryam Amina Ali, RN
• Mohamed A Ali
• Mohamed Abukar Ali
• Mohammed Bashir Ali
• Mohamoud Ali, M.D.
• Muna Ali
• Muna Munye Ali
• Munassar Ali

• General Practice Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.