Allyssa Rae Ostrowski, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

108170 Issued in CA

Practice address

585 Tahoe Keys Blvd Ste 2
South Lake Tahoe, CA 96150-3371

Phone

(732) 963-7960

NPI assigned

Jun 22, 2022

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1285365031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 TAHOE KEYS BLVD STE 2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503371",
            "telephone_number": "732-963-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 TAHOE KEYS BLVD STE 2",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503371",
            "telephone_number": "732-963-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROWSKI",
        "first_name": "ALLYSSA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "DGD.10230",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Orr, MD
• Lance Matthew Orr, MD
• Terrence R Orr, MD
• Mireya Ortega, DDS
• Stephen Osterberg
• Sabrina Owen, LMFT
• Michael Dominick Pardo, CADC
• Eric Song Joon Park, D.D.S.
• Jill Parmele, OTR
• Marianne Elizabeth Patino, DPT

• Dentist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.