MEDICARE: DR. ALI BADIHI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	015356	MO

General Provider Information

NPI Number	:	1134117054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI BADIHI DDS

Provider Business Mailing Address
First Line	:	500 NORTHWEST PLZ
Second Line	:
City	:	SAINT ANN
State	:	MO
Zip	:	63074-2220
Country	:	US
Telephone Number	:	314-739-7908
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 NORTHWEST PLZ
Second Line	:
City	:	SAINT ANN
State	:	MO
Zip	:	63074-2209
Country	:	US
Telephone Number	:	314-739-7908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	07/09/2007

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