Ashley Marmar Alavizadeh
Individual provider Active NPI Dentist · Downey, CA
NPI 1508065194 · NPPES record last updated Apr 8, 2016
Key facts
- NPI
- 1508065194
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 55844 (CA)
- Practice address
- 9906 Imperial Hwy
Downey, CA 90242-3207 - Phone
- (562) 803-9600
- Fax
- (562) 803-1025
- NPI assigned
- Jul 13, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55844 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 55844 | CA | Yes |
Addresses
Primary practice location
9906 Imperial Hwy
Downey, CA 90242-3207
Mailing address
PO Box 370265
#202
Reseda, CA 91337-0265
Phone (214) 293-1597
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D55844 | Medicaid | CA |
Other providers in Downey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.