Provider Demographics
NPI:1386747384
Name:LUCERO, ALEXIA ROXANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:ROXANNE
Last Name:LUCERO
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 1:516 W REMINGTON DR
Mailing Address - Street 2:SUITE 4C
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2470
Mailing Address - Country:US
Mailing Address - Phone:408-738-0803
Mailing Address - Fax:
Practice Address - Street 1:516 W REMINGTON DR
Practice Address - Street 2:SUITE 4C
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2470
Practice Address - Country:US
Practice Address - Phone:408-738-0803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist