Individual provider Active NPI

Alireza Amiri, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1265567713
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55040 Issued in CA
Practice address
10865 La Alberca Ave
San Diego, CA 92127-3318
Phone
(858) 361-1832
Fax
(858) 487-5396
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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 55040 CA Primary

Addresses

Primary practice location

10865 La Alberca Ave
San Diego, CA 92127-3318

Mailing address

10865 La Alberca Ave
San Diego, CA 92127-3318
Phone (858) 361-1832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
55040CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1265567713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10865 LA ALBERCA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273318",
            "telephone_number": "858-361-1832",
            "fax_number": "858-487-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10865 LA ALBERCA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273318",
            "telephone_number": "858-361-1832",
            "fax_number": "858-487-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRI",
        "first_name": "ALIREZA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.