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General NPI Number Information
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NPI Number | 1821780339
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Entity Type | Individual
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Provider Name | DAVID ALISHAYEV
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Gender | Male
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 25 SE 2ND AVE STE 336
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City | MIAMI
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State | FL
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Zip | 33131-1543
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Country | US
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Telephone | 305-645-4166
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Fax |
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Provider Business Mailing Address
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Address Line | 5170 SW 40TH AVE APT 1E
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City | FORT LAUDERDALE
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State | FL
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Zip | 33314-5753
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27895
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License Number State | FL
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