Healthcare Provider Details

I. General information

NPI: 1497965636
Provider Name (Legal Business Name): ALI ALVIRI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23162 LOS ALISOS BLVD STE 103B
MISSION VIEJO CA
92691-7861
US

IV. Provider business mailing address

23162 LOS ALISOS BLVD STE 103B
MISSION VIEJO CA
92691-7861
US

V. Phone/Fax

Practice location:
  • Phone: 949-328-9297
  • Fax: 949-328-9294
Mailing address:
  • Phone: 949-328-9297
  • Fax: 949-328-9294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number39126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: