Provider Demographics
NPI:1033218870
Name:ASSADIAN, ALIREZA (MS, DDS)
Entity Type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:ASSADIAN
Suffix:
Gender:M
Credentials:MS, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 CANNON RD STE 2G
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4981
Mailing Address - Country:US
Mailing Address - Phone:760-945-7000
Mailing Address - Fax:760-945-7300
Practice Address - Street 1:3529 CANNON RD STE 2G
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4981
Practice Address - Country:US
Practice Address - Phone:760-945-7000
Practice Address - Fax:760-945-7300
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA450881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice