Individual provider Active NPI

Yasir Alsarraj, DDS

  • General Practice Dentistry
  • Washington, PA
National Provider Identifier
1083222947
Registry record updated May 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4678 Issued in WV
Practice address
106 Trinity Point Dr
Washington, PA 15301-2977
Phone
(724) 298-2120
NPI assigned
Jul 16, 2020
Last updated
May 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4678 WV Primary

Addresses

Primary practice location

106 Trinity Point Dr
Washington, PA 15301-2977

Mailing address

46 Summers Ridge Rd
Morgantown, WV 26508-1128
Phone (909) 713-9699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241218002591 WV Order and Referring Only - DentistPractitioner - Dentist 0446787295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4678WVMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Orthodontics, PLLC PastSince Jul 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747440000000",
    "number": "1083222947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 SUMMERS RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081128",
            "telephone_number": "909-713-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 TRINITY POINT DR",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012977",
            "telephone_number": "724-298-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALSARRAJ",
        "first_name": "YASIR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2025-05-17",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.