Active NPI
Alissa Bordow, D.D.S.
- General Practice Dentistry
- San Francisco, CA
National Provider Identifier
1447547369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61805
- Practice address
- 187 Pine St
San Francisco, CA 94111-5527 - Phone
- (415) 397-4433
- NPI assigned
- Jun 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 61805 | CA | Primary |
Addresses
Primary practice location
187 Pine St
San Francisco, CA 94111-5527
Mailing address
2350 Union St
Apt 11
San Francisco, CA 94123-3936
Phone (707) 477-6738
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 |
|---|---|---|---|
| 61805 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365379200000",
"number": "1447547369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 UNION ST",
"address_2": "APT 11",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941233936",
"telephone_number": "707-477-6738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 PINE ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941115527",
"telephone_number": "415-397-4433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDOW",
"first_name": "ALISSA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-29",
"last_updated": "2013-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "61805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.