Individual provider Active NPI

Ali Soulati, DDS

  • Dentist
  • Easton, MD
National Provider Identifier
1306822796
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13057 Issued in MD
Practice address
508A Cynwood Dr
Easton, MD 21601-3805
Phone
(410) 819-0060
Fax
(410) 819-0331
NPI assigned
Dec 19, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13057 MD Primary

Addresses

Primary practice location

508A Cynwood Dr
Easton, MD 21601-3805

Mailing address

508A Cynwood Dr
Easton, MD 21601-3805
Phone (410) 819-0060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608001328 MD Order and Referring Only - DentistPractitioner - Dentist 6608197256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13057MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ali Soulati DDS LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306822796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508A CYNWOOD DR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013805",
            "telephone_number": "410-819-0060",
            "fax_number": "410-819-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508A CYNWOOD DR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013805",
            "telephone_number": "410-819-0060",
            "fax_number": "410-819-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULATI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.