Healthcare Provider Details

I. General information

NPI: 1730024340
Provider Name (Legal Business Name): FARIDA ALI DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 NJ-34
OLD BRIDGE NJ
08857
US

IV. Provider business mailing address

30 JERNEE DR
EAST BRUNSWICK NJ
08816-5308
US

V. Phone/Fax

Practice location:
  • Phone: 848-219-4408
  • Fax:
Mailing address:
  • Phone: 848-219-4408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FARIDA ALI
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 848-219-4408