Provider Demographics
NPI:1528899036
Name:ALAIE DENTAL GROUP, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ALAIE DENTAL GROUP, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOUSHAFARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-451-4148
Mailing Address - Street 1:1234 STONE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2028
Mailing Address - Country:US
Mailing Address - Phone:925-451-4148
Mailing Address - Fax:
Practice Address - Street 1:3365 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2834
Practice Address - Country:US
Practice Address - Phone:925-602-9777
Practice Address - Fax:925-602-9774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental