DR. ALEXANDER KAREEM DESTA (NPI# 1477702629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477702629 |
| Entity Type | Individual |
| Full Name | DR. ALEXANDER KAREEM DESTA |
| Credential | D.D.S. |
| Practice Address |
43000 Midway Ave Bldg 595 San Diego CA 92140-1884 |
| Mailing Address |
11447 Monticook Ct San Diego CA 92127-3128 |
| Practice Telephone | 6195244009 |
| Mailing Telephone | 8083895802 |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2020-02-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 57679 | CA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
57679 | CA | Dental Providers |
| Street Address |
43000 MIDWAY AVE BLDG 595 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92140-1884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609916568 | Stephen R Hoyem | Dentist | 43000 Midway Ave Bldg 595, Mcrd, San Diego, CA 92140-5692 | 2007-02-07 |
| 1649897109 | Laura Thomas | Dentist | 43000 Midway Ave Bldg 595, San Diego, CA 92140-5692 | 2020-07-01 |
| 1063063774 | Kyoung Won Han | Dentist | 43000 Midway Ave Bldg 595, San Diego, CA 92140-5692 | 2019-09-24 |
| 1922655000 | Monica Haewon Lee | Dentist | 43000 Midway Ave Bldg 595, San Diego, CA 92140-5692 | 2019-08-22 |
| 1992221659 | Marcus Andrew Thayn | Dentist | 43000 Midway Ave Bldg 595, San Diego, CA 92140-5692 | 2017-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528549177 | Shelly K Gareiss | Dentist | Mcrd San Diego, 3800 Chosin Avenue, San Diego, CA 92140 | 2018-08-22 |
| 1700185303 | Rachel Ann Holloway | Physician Assistant | 35000 Guadalcanal Street, Bhc Mcrd, San Diego, CA 92140 | 2011-03-22 |
| 1215158027 | Susan Rohbock | Physician Assistant | Navy Medical Clinic - Marine Corps Recruit Depot, 35000 Guadalcanal St., San Diego, CA 92140 | 2007-05-01 |
| 1700927514 | Anthony Joseph Marciante | Dentist | Branch Dental Clinic Mcrd, 43000 Midway Ave, Bldg 595, San Diego, CA 92140 | 2007-02-12 |
| 1861539488 | Justin Oderkirk | Emergency Medical Technician, Basic | 1650 Henderson Ave, Bldg 310, San Diego, CA 92140 | 2007-01-31 |
| 1437240777 | Karima Ayesh | Dentist | 34000 Midway Ave, Bldg 595, Apo, AA 92140 | 2006-09-28 |
| 1730288788 | Naval Medical Center San Diego | Military/U.S. Coast Guard Pharmacy | 25000 Guadal Canal Rd, Bldg 256, San Diego, CA 92140 | 2006-09-22 |
| 1306800644 | Reynaldo L Reyes Jr. | Military Health Care Provider | 35000 Guadalcanal St, Branch Medical Clinic Marine Corps Recruit Depot, San Diego, CA 92140 | 2006-04-13 |
| 1932161197 | Reynaldo Aldover Guadez | Military Health Care Provider | Branch Medical Clinic Mcrd, 35000 Guadalcanal Street, San Diego, CA 92140 | 2006-04-04 |
| 1730151648 | Richard William Skinner | General Practice | Branch Clinic Marine Corps Recruit Depot, 35000 Guadalcanal Ave, San Diego, CA 92140 | 2006-02-03 |
| Find all providers in zip 92140 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245716950 | Erik Balinghasay | Dentist | 12750 Carmel Country Rd Ste 201, San Diego, CA 92130-2171 | 2018-07-16 |
| 1770010795 | Elenaz Sarshar | Dentist | 6750 Beadnell Way Unit 49, San Diego, CA 92117-5148 | 2017-05-22 |
| 1174973507 | Duc Huynh Nguyen | Dentist | 5830 Oberlin Dr Ste 103, San Diego, CA 92121-3753 | 2016-06-16 |
| 1184004517 | Sheena Howell Dmd, Inc | Dentist | 522 Thorn St, San Diego, CA 92103-5710 | 2015-06-01 |
| 1457774192 | Anthony Potente | Dentist | 4033 3rd Ave Ste 303, San Diego, CA 92103-2117 | 2014-01-31 |
| 1306156823 | Kelvin Chou | Dentist | 5783 Mission Center Rd Apt 307, San Diego, CA 92108-4918 | 2010-10-18 |
| 1285942532 | Sean Daniels | Dentist | 9750 Miramar Rd Ste 375, San Diego, CA 92126-7503 | 2010-09-21 |
| 1891950937 | William A Walker | Dentist | 2615 Clairemont Dr, San Diego, CA 92117-6634 | 2008-07-28 |
| 1891966008 | Edward William Jerge | Dentist | 3762 Clairemont Dr, San Diego, CA 92117-5916 | 2008-03-14 |
| 1750570354 | Eugene Charles Hanson | Dentist | 4065 3rd Ave Ste 300, San Diego, CA 92103-2184 | 2007-10-18 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.