Ejaz Ali, DMD
Individual provider Active NPI Dentist · Wellesley, MA
NPI 1992914980 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992914980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 18473 (MA)
- Practice address
- 5 Seaward Rd
Wellesley, MA 02481-7510 - Phone
- (781) 237-9071
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 18473 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Ali and Ali, PC | Past | Accepting new patients | |
| 42 North Dental Care, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 18473 | MA | Yes |
Addresses
Primary practice location
5 Seaward Rd
Wellesley, MA 02481-7510
Mailing address
5 Seaward Rd
Wellesley, MA 02481-7510
Phone (781) 237-9071
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X11612 | Other | BLUE CROSS BLUE SHIELD |
Other providers in Wellesley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.