Healthcare Provider Details

I. General information

NPI: 1669161469
Provider Name (Legal Business Name): CORI ALAINE FINE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1559 PACIFIC COAST HWY
HERMOSA BEACH CA
90254-3214
US

IV. Provider business mailing address

8130 W 83RD ST APT 3
PLAYA DEL REY CA
90293-7851
US

V. Phone/Fax

Practice location:
  • Phone: 310-372-7686
  • Fax:
Mailing address:
  • Phone: 845-709-5828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS111909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: