MEDICARE: ALYSSA WORKS IZIC DDS

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	122300000X	Dentist	10499	NC

General Provider Information

NPI Number	:	1851743736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA WORKS IZIC DDS

Provider Business Mailing Address
First Line	:	200 E 2ND AVE
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28052-4358
Country	:	US
Telephone Number	:	704-874-1904
Fax Number	:	704-867-2134

Provider Business Practice Location Address
First Line	:	32 KIRKWOOD AVE
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-4024
Country	:	US
Telephone Number	:	336-243-3201
Fax Number	:	336-843-2005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	04/07/2026

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Directions to “ ALYSSA WORKS IZIC DDS” Practice Location

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