Provider Demographics
NPI:1336235464
Name:LEDDA, ALEGRIA LOPEZ (DDS)
Entity type:Individual
Prefix:
First Name:ALEGRIA
Middle Name:LOPEZ
Last Name:LEDDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 SONOMA BLVD
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-2946
Mailing Address - Country:US
Mailing Address - Phone:707-319-7484
Mailing Address - Fax:
Practice Address - Street 1:3630 SONOMA BLVD
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-2946
Practice Address - Country:US
Practice Address - Phone:707-319-7484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist