Active NPI
Alexander Ryan Powell, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Sacramento, CA
National Provider Identifier
1235690124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- D104060
- Practice address
- 4350 Marconi Ave Ste 200
Sacramento, CA 95821-4379 - Phone
- (916) 483-4379
- NPI assigned
- Mar 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D104060 | CA | Primary |
Addresses
Primary practice location
4350 Marconi Ave Ste 200
Sacramento, CA 95821-4379
Mailing address
6013 Sundale CT
El Dorado Hills, CA 95762-7648
Phone (909) 263-6540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 8, 2025 through Oct 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104060 | CA | MD | Mental Health Counselor |
| D104060 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1235690124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6013 SUNDALE CT",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957627648",
"telephone_number": "909-263-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 MARCONI AVE STE 200",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958214379",
"telephone_number": "916-483-4379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "ALEXANDER",
"middle_name": "RYAN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-25",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "D104060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.