DR. ALI POOTRAKUL (NPI# 1386795961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386795961 |
| Entity Type | Individual |
| Full Name | DR. ALI POOTRAKUL |
| Credential | D.D.S |
| Practice Address |
16002 Hawthorne Blvd Lawndale CA 90260-2646 |
| Mailing Address |
8811 169th St Oral Surgeon Suite 1st Fl. Jamaica NY 11432-4430 |
| Practice Telephone | 3103714104 |
| Mailing Telephone | 7186581200 |
| Mailing Fax Number | 7186581484 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2019-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
60258 | CA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
052450 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02891830 | 05 |
| Street Address |
16002 HAWTHORNE BLVD |
| City | LAWNDALE |
| State | CA |
| Zip Code | 90260-2646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053669101 | Tabibi Dental Corporation | Dentist | 16002 Hawthorne Blvd, Lawndale, CA 90260-2646 | 2012-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063050441 | Medical Legal Experts Mle | Specialist/Technologist, Other | 4623 Hawthorne Blvd., Suite 401, Lawndale, CA 90260 | 2019-12-16 |
| 1730659392 | Spine Pro Tardaguila Chiropractic and Pt Rehab Corp | Chiropractor | 15901 Hawthorne Blvd. 160, Lawndale, CA 90260 | 2018-11-27 |
| 1356810758 | Jason H. Ta, Dmd, Inc. | Dentist | 16709 Hawthorne Blvd., Lawndale, CA 90260 | 2018-11-15 |
| 1437631868 | Careplus Palliative Inc. | Hospice Care, Community Based | 14708 Hawthorne Blvd Suite 8, Lawndale, CA 90260 | 2018-09-01 |
| 1083072664 | Joann Kim Ha Tran | Dentist | 15655 Hawthorne Blvd Ste A, Lawndale, CA 90260 | 2016-02-10 |
| 1598134785 | Stephanie Galang | Specialist/Technologist | 15413 Cranbrook Ave., Lawndale, CA 90260 | 2015-09-18 |
| 1275929804 | Healthy Heart Home Care | Home Health | 15901 Hawthorne Bl, Ste. 410, Lawndale, CA 90260 | 2015-04-10 |
| 1699190496 | Stephanie Ann Cross | Chiropractor | 14623 Hawthorne Blvd Ste 207, Lawndale, CA 90260 | 2014-03-03 |
| 1659681773 | Sorour Dmd PC | Dentist | 14979 Praire Ave, Lawndale, CA 90260 | 2010-10-08 |
| 1669625430 | Safety Works Medical, Inc | Chiropractor | 14623 Hawthorne Blvd., Suite 207, Lawndale, CA 90260 | 2008-10-24 |
| Find all providers in zip 90260 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568670305 | David Wayne Stephens | Dentist | 14610 Hawthorne Blvd, Lawndale, CA 90260-1521 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1316568900 | Beech & Reid Dental Partnership | Dentist | 464 E Calaveras Blvd Ste B3, Milpitas, CA 95035-5412 | 2020-05-05 |
| 1518506773 | Francisco Suarez, Dds Inc. | Dentist | 4606 Hollywood Blvd Ste A, Los Angeles, CA 90027-5462 | 2020-01-04 |
| 1831748839 | Slate Dental Corporation | Dentist | 6512 Lonetree Blvd Ste 100, Rocklin, CA 95765-5883 | 2019-09-11 |
| 1255980140 | Dr Maloux Macasaet Saguin Dental Corporation | Dentist | 9800 Topanga Canyon Blvd Ste J, Chatsworth, CA 91311-4075 | 2019-09-04 |
| 1891342267 | Amrollahie and Riman Dental Partnership | Dentist | 1442 Irvine Blvd Ste 225, Tustin, CA 92780-3846 | 2019-08-21 |
| 1548821572 | Hoang Dental Corporation | Dentist | 1356 W Valley Pkwy Ste J, Escondido, CA 92029-2138 | 2019-06-20 |
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
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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.