MEDICARE: ALAMEDA DENTAL CARE, PLLC

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	261QD0000X	Dental Clinic/Center	26272	TX
2	122300000X	Dentist

General Provider Information

NPI Number	:	1821523473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAMEDA DENTAL CARE, PLLC

Provider Business Mailing Address
First Line	:	100 S AMERICAS AVE STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-6901
Country	:	US
Telephone Number	:	915-858-5862
Fax Number	:	844-800-0070

Provider Business Practice Location Address
First Line	:	100 S AMERICAS AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-6901
Country	:	US
Telephone Number	:	915-858-5862
Fax Number	:	844-800-0070

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	AMIR A YAVARI
Credential	:	DDS
Telephone Number	:	310-430-2387

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	06/08/2026

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