DR. ALIREZA KHANSARI DDS MSD NPI 1821183864

NPI Information

  • NPI: 1821183864
  • Provider Name: DR. ALIREZA KHANSARI, DDS, MSD
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 12630 MONTE VISTA ROAD. #204
    POWAY, CA
    ZIP 92064
  • Phone: (858) 679-0142

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NPI Details

DR. Alireza Khansari, DDS, MSD is a periodontics dentist in Poway, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Alireza Khansari, DDS, MSD NPI is 1821183864. 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:

12630 MONTE VISTA ROAD. #204
POWAY, CA
ZIP 92064
Phone: (858) 679-0142
Fax: (858) 679-0165

The NPI 1821183864 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/4/2006 and was last updated on 8/5/2025.

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
11223P0300XDentistPeriodontics49590CALIFORNIAYes

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: 11/21/2025

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