Provider Demographics
NPI:1053753723
Name:ALANI, WESAM (DMD)
Entity type:Individual
Prefix:MR
First Name:WESAM
Middle Name:
Last Name:ALANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 GUNBARREL RD STE 400B
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4796
Mailing Address - Country:US
Mailing Address - Phone:423-713-7333
Mailing Address - Fax:423-713-7334
Practice Address - Street 1:1825 GUNBARREL RD STE 400B
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4796
Practice Address - Country:US
Practice Address - Phone:423-713-7333
Practice Address - Fax:423-713-7334
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN97331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNW13059210COtherDEA