Active NPI
Alida Brscic-Biasi, D.D.S.
- General Practice Dentistry
- San Pedro, CA
National Provider Identifier
1326141292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 36056
- Practice address
- 545 W. 9TH St
Suite #3
San Pedro, CA 90731-3131 - Phone
- (310) 514-2717
- Fax
- (310) 514-2717
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 36056 | CA | Primary |
Addresses
Primary practice location
545 W. 9TH St
Suite #3
San Pedro, CA 90731-3131
Mailing address
545 W. 9TH Street
Suite #3
San Pedro, CA 90731-3131
Phone (310) 514-2717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36056 | Other | CA | CALIFORNIA LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36056 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326141292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 W. 9TH STREET",
"address_2": "SUITE #3",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907313131",
"telephone_number": "310-514-2717",
"fax_number": "310-514-2717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 W. 9TH ST",
"address_2": "SUITE #3",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907313131",
"telephone_number": "310-514-2717",
"fax_number": "310-514-2717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRSCIC-BIASI",
"first_name": "ALIDA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "36056",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA LICENSE NUMBER",
"identifier": "36056",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Pedro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.