Individual
DR. ALIREZA SADRE-NASSIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
925 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8382
(707) 263-5326
Mailing address
PO BOX 1950, LAKEPORT, CA 95453-1950
(707) 263-8382
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
056780
NY
122300000X
Dentist
60737991
WA
1223P0221X
Pediatric Dentistry
056780
NY
1223P0221X
Pediatric Dentistry
Primary
109541
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1223G0001X
—
CT
Enumeration date
06/28/2012
Last updated
08/01/2025
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