Individual provider Active NPI

Ahmed Sherif Aly, D.D.S

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1811612864
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.027744 Issued in OH
Practice address
5969 E Broad Street, Suite 303
Columbus, OH 43213
Phone
(614) 626-8822
NPI assigned
Oct 11, 2022
Reactivated
Jun 28, 2023
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.027744 OH Primary

Addresses

Primary practice location

5969 E Broad Street, Suite 303
Columbus, OH 43213

Mailing address

1684 Canvasback Lane
Columbus, OH 43215
Phone (216) 375-9103

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

LicenseStateTypeSpecialty
30.027744OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1811612864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 CANVASBACK LANE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43215",
            "telephone_number": "216-375-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5969 E BROAD STREET, SUITE 303",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-626-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALY",
        "first_name": "AHMED",
        "middle_name": "SHERIF",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-11",
        "last_updated": "2025-01-08",
        "certification_date": "2023-06-28",
        "deactivation_date": "2023-05-15",
        "reactivation_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.