Individual provider Active NPI

Alisa Alvaro, D.D.S.

  • General Practice Dentistry
  • San Leandro, CA
National Provider Identifier
1508912676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39506 Issued in CA
Practice address
345 Estudillo Ave
San Leandro, CA 94577-4702
Phone
(510) 895-1776
Fax
(510) 895-4440
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39506 CA Primary

Addresses

Primary practice location

345 Estudillo Ave
San Leandro, CA 94577-4702

Mailing address

518 Missouri St
San Francisco, CA 94107-2837
Phone (415) 924-7641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160819002149 CA Order and Referring Only - DentistPractitioner - Dentist 1254626997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39506CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508912676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 MISSOURI ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941072837",
            "telephone_number": "415-924-7641",
            "fax_number": "415-970-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 ESTUDILLO AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774702",
            "telephone_number": "510-895-1776",
            "fax_number": "510-895-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVARO",
        "first_name": "ALISA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.