Individual provider Active NPI

Ashkan Alizadeh, D.D.S.

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1215045117
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
51543 Issued in CA
Practice address
2619 J St
Sacramento, CA 95816-4312
Phone
(916) 443-5677
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 050834-1 NY
General Practice Dentistry 1223G0001X 51543 CA Primary

Addresses

Primary practice location

2619 J St
Sacramento, CA 95816-4312

Mailing address

2619 J St
Sacramento, CA 95816-4312
Phone (916) 443-5677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150716000261 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1052624384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51543CAMDMental Health Counselor
050834-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alizadeh & Saleh, DDS, Inc General Practice Current Accepting new patients
Alizadeh & Saleh DDS Inc. CurrentSince Mar 22, 2012 Accepting new patients

Locations

4350 Marconi Ave
Ste 100
Sacramento, CA 95821
Phone (916) 487-7148

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1215045117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164312",
            "telephone_number": "916-443-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164312",
            "telephone_number": "916-443-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALIZADEH",
        "first_name": "ASHKAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050834-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.