Healthcare Provider Details

I. General information

NPI: 1417294463
Provider Name (Legal Business Name): USMILE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8675 S PRIEST DR
TEMPE AZ
85284-1914
US

IV. Provider business mailing address

PO BOX 2924
SCOTTSDALE AZ
85252-2924
US

V. Phone/Fax

Practice location:
  • Phone: 480-208-7436
  • Fax: 866-316-7796
Mailing address:
  • Phone: 480-208-7436
  • Fax: 866-316-7796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHDI ALI
Title or Position: OWNER
Credential: DMD
Phone: 480-208-7436