Healthcare Provider Details

I. General information

NPI: 1013862572
Provider Name (Legal Business Name): BIGHDAD ALI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 GOSFORD RD STE 103
BAKERSFIELD CA
93313-4969
US

IV. Provider business mailing address

13821 FARINGFORD LN
BAKERSFIELD CA
93311-8680
US

V. Phone/Fax

Practice location:
  • Phone: 661-588-2065
  • Fax:
Mailing address:
  • Phone: 661-378-6572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: