Alexander Kareem Desta, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

57679 Issued in CA

Practice address

43000 Midway Ave BLDG 595
San Diego, CA 92140-1884

Phone

(619) 524-4009

NPI assigned

Sep 11, 2008

Sex

Male

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": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1477702629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11447 MONTICOOK CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273128",
            "telephone_number": "808-389-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43000 MIDWAY AVE BLDG 595",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921401884",
            "telephone_number": "619-524-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTA",
        "first_name": "ALEXANDER",
        "middle_name": "KAREEM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57679",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "57679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myra Desquitado-Prado
• Derek Reece Desrosiers
• Patricia J Desrosiers
• Gary Desrouilleres, PTA
• Marianne Elyse Dessert
• Taddese Teferi Desta, M.D.
• Emily Paige Destefano, ND
• Destiny Medical Supplies
• Latoya Desue, LMFT
• Ajai Scott Desulme

• Endodontics in San Diego, CA
• Providers in San Diego, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.