Provider Demographics
NPI:1366541658
Name:GHASSEMI, ALIREZA RAMIN (DDS MS)
Entity type:Individual
Prefix:
First Name:ALIREZA
Middle Name:RAMIN
Last Name:GHASSEMI
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12750 CARMEL COUNTRY RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130
Mailing Address - Country:US
Mailing Address - Phone:858-481-8107
Mailing Address - Fax:858-481-8127
Practice Address - Street 1:12750 CARMEL COUNTRY RD
Practice Address - Street 2:SUITE 213
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130
Practice Address - Country:US
Practice Address - Phone:858-481-8107
Practice Address - Fax:858-481-8127
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA405951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice