DR. ALIREZA SADRE-NASSIRI D.M.D. NPI 1740544303

NPI Information

NPI: 1740544303
Provider Name: DR. ALIREZA SADRE-NASSIRI, D.M.D.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
6003 100TH ST SW
LAKEWOOD, WA
ZIP 98499
Phone: (425) 466-0595
Get Directions

DR. Alireza Sadre-nassiri, D.M.D. is a pediatric dentistry dentist in Lakewood, WA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Alireza Sadre-nassiri, D.M.D. NPI is 1740544303. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6003 100TH ST SW
LAKEWOOD, WA
ZIP 98499-733
Phone: (425) 466-0595

The enumeration date for this NPI number is 6/28/2012 and was last updated on 2/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		056780	NEW YORK	No
2	1223P0221X	Dentist	Pediatric Dentistry	056780	NEW YORK	No
3	1223P0221X	Dentist	Pediatric Dentistry	109541	CALIFORNIA	Yes
4	122300000X	Dentist		60737991	WASHINGTON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1223G0001X	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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