Active NPI
Alex B Avanessian, D.D.S.
- Periodontics
- La Jolla, CA
National Provider Identifier
1942202098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 43518
- Practice address
- 7334 Girard Ave
Ste 204
La Jolla, CA 92037-5141 - Phone
- (858) 459-0858
- Fax
- (858) 459-0878
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 43518 | CA | Primary |
Addresses
Primary practice location
7334 Girard Ave
Ste 204
La Jolla, CA 92037-5141
Mailing address
7334 Girard Ave
Ste 204
La Jolla, CA 92037-5141
Phone (858) 459-0858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43518 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942202098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7334 GIRARD AVE",
"address_2": "STE 204",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920375141",
"telephone_number": "858-459-0858",
"fax_number": "858-459-0878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7334 GIRARD AVE",
"address_2": "STE 204",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920375141",
"telephone_number": "858-459-0858",
"fax_number": "858-459-0878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVANESSIAN",
"first_name": "ALEX",
"middle_name": "B",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "43518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
- Catherine Ann Austin, L.AC.
- Ryan Patrick Austin, M.D.
- Johana Austria, FNP
- Iman Amira Autman
- Tammy Auyeung, PA-C
- Avantgarde Senior Living of la Jolla
- Bryan Stephen Avilez
- Ayman Naser DDS Inc (The Shores Dental)
- Azadeh Shirazi MD Inc (La Jolla Dermatology & Laser Surgery Center)
- Paricheh Azimi, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.