Khaled Ishaq Ali, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012592 Issued in AZ

Practice address

1325 W Duval Mine Rd Ste 179
Green Valley, AZ 85614-5293

Phone

(520) 867-6406

Fax

(520) 214-0069

NPI assigned

Jul 29, 2025

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

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1891678652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 W DUVAL MINE RD STE 179",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145293",
            "telephone_number": "520-867-6406",
            "fax_number": "520-214-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W DUVAL MINE RD STE 179",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145293",
            "telephone_number": "520-867-6406",
            "fax_number": "520-214-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "KHALED",
        "middle_name": "ISHAQ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aegis Group Practice LLC
• Akdhc - Umc Green Valley Clinic
• Akdhc, LLC
• Akdhc, LLC
• Akdhc, LLC
• Alix Phillips, DMD, Inc.
• Anthony Alexander Allen, C. PED.
• Anne Marie Almoite Almirol, PT
• Alvernon Optical, Inc.
• American Foot Care Clinic PLLC

• All providers in Green Valley, AZ
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.