MEDICARE: ALIAA ALBABA DMD

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	122300000X	Dentist	DN28155	FL

General Provider Information

NPI Number	:	1871279703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIAA ALBABA DMD

Provider Business Mailing Address
First Line	:	20441 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2759
Country	:	US
Telephone Number	:	813-866-9913
Fax Number	:

Provider Business Practice Location Address
First Line	:	20441 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2759
Country	:	US
Telephone Number	:	813-866-9913
Fax Number	:

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

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	06/17/2025

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