Individual provider Active NPI

Alia Osseiran, DMD

  • Dentist
  • Port Charlotte, FL
National Provider Identifier
1497497044
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27655 Issued in FL
Practice address
1720 Tamiami TRL Ste 102
Port Charlotte, FL 33948-1121
Phone
(941) 584-8926
NPI assigned
Apr 12, 2022
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27655 FL Primary

Addresses

Primary practice location

1720 Tamiami TRL Ste 102
Port Charlotte, FL 33948-1121

Mailing address

1720 Tamiami TRL Ste 102
Port Charlotte, FL 33948-1121
Phone (941) 584-8926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221103000942 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456728401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27655FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Port Charlotte, PA Dentist CurrentSince Nov 19, 2023 Accepting new patients

Locations

1720 Tamiami Trl
Ste 102
Port Charlotte, FL 33948
Phone (941) 584-8926

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1497497044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 TAMIAMI TRL STE 102",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481121",
            "telephone_number": "941-584-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 TAMIAMI TRL STE 102",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481121",
            "telephone_number": "941-584-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSSEIRAN",
        "first_name": "ALIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "27655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.