MEDICARE: ALEXANDRIA N. ARDITTI DDS, DENTAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	64749	CA

General Provider Information

NPI Number	:	1326576554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDRIA N. ARDITTI DDS, DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	18800 DELAWARE ST STE 700
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6018
Country	:	US
Telephone Number	:	909-499-0713
Fax Number	:

Provider Business Practice Location Address
First Line	:	18800 DELAWARE ST STE 700
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6018
Country	:	US
Telephone Number	:	909-499-0713
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEXANDRIA NICOLE ARDITTI
Credential	:	DDS
Telephone Number	:	909-499-0713

Provider Enumeration Date	:	06/01/2017
Last Update Date	:	07/21/2022

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