Provider Demographics
NPI:1366874497
Name:AIT OUBELLI, ANIA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANIA
Middle Name:
Last Name:AIT OUBELLI
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5808
Mailing Address - Country:US
Mailing Address - Phone:212-227-8401
Mailing Address - Fax:
Practice Address - Street 1:DENTISTE
Practice Address - Street 2:
Practice Address - City:MONTREAL
Practice Address - State:QUEBEC
Practice Address - Zip Code:H8N1X3
Practice Address - Country:CA
Practice Address - Phone:514-595-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056818-01122300000X
NY50 056818122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist