Healthcare Provider Details

I. General information

NPI: 1295582906
Provider Name (Legal Business Name): ALY GAMEE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 E 130TH ST
CHICAGO IL
60628-6908
US

IV. Provider business mailing address

5 WASHINGTON ST
WEST WARWICK RI
02893-4927
US

V. Phone/Fax

Practice location:
  • Phone: 773-846-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN10000053
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.035723
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN03721
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: