Provider Demographics
NPI:1841032729
Name:ALIREZA KARBASSI INC
Entity type:Organization
Organization Name:ALIREZA KARBASSI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARBASSI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MSD
Authorized Official - Phone:330-929-8080
Mailing Address - Street 1:820 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1014
Mailing Address - Country:US
Mailing Address - Phone:330-929-8080
Mailing Address - Fax:330-929-8719
Practice Address - Street 1:820 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1014
Practice Address - Country:US
Practice Address - Phone:330-929-8080
Practice Address - Fax:330-929-8719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KARASSI ORTHODONTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH066560Medicaid