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General NPI Number Information
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NPI Number | 1316938228
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Entity Type | Individual
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Provider Name | ALI R SEDIGHIAN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 9005 CHEVROLET DR SUITE 1
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-4009
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Country | US
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Telephone | 410-465-3021
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Fax |
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Provider Business Mailing Address
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Address Line | 9005 CHEVROLET DR SUITE 1
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-4009
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Country | US
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Telephone | 410-465-3021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12016
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License Number State | MD
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