Individual provider Active NPI

Alex R. Sharifian, DDS

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1083625792
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44540 Issued in CA
Practice address
2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone
(714) 508-3600
Fax
(714) 368-2092
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6274 AZ
General Practice Dentistry 1223G0001X 4908 NV
General Practice Dentistry 1223G0001X 2012027620 MO
General Practice Dentistry 1223G0001X 9057 SC
General Practice Dentistry 1223G0001X 61076 KS
General Practice Dentistry 1223G0001X 0401415880 VA
General Practice Dentistry 1223G0001X 44540 CA Primary

Addresses

Primary practice location

2860 Michelle
2ND Floor
Irvine, CA 92606-1009

Mailing address

13721 Newport Ave
Ste. 1
Tustin, CA 92780-4690
Phone (714) 368-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150713000203 MO Order and Referring Only - DentistPractitioner - Dentist 3870805328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6274AZMDGeneral Practice Dentistry
61076KSMDGeneral Practice Dentistry
2012027620MOMDGeneral Practice Dentistry
4908NVMDGeneral Practice Dentistry
0401415880VAMDGeneral Practice Dentistry
44540CAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharifian Dental Corporation General Practice Past Accepting new patients
Las Tiendas Dental Group, LLP General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1083625792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13721 NEWPORT AVE",
            "address_2": "STE. 1",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804690",
            "telephone_number": "714-368-1400",
            "fax_number": "714-368-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFIAN",
        "first_name": "ALEX",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6274",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4908",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2012027620",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9057",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61076",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415880",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.