Alexander Pritsky, D.M.D.
Individual provider Active NPI Periodontics · Fresno, CA
NPI 1750418604 · NPPES record last updated Feb 12, 2014
Key facts
- NPI
- 1750418604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 52672 (CA)
- Practice address
- 7045 N Chestnut Ave
#102
Fresno, CA 93720-0354 - Phone
- (559) 298-3900
- Fax
- (559) 298-3920
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160603000695 | CA | Order and Referring Only - Dentist |
4587954599 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alexander Pritsky, DMD, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 52672 | CA | Yes |
Addresses
Primary practice location
7045 N Chestnut Ave
#102
Fresno, CA 93720-0354
Mailing address
7045 N Chestnut Ave
#102
Fresno, CA 93720-0354
Phone (559) 298-3900
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.