Provider Demographics
NPI:1386873438
Name:WINTER, ALEX
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:WINTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 STONEWOOD STREET
Mailing Address - Street 2:SUITE 471
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241
Mailing Address - Country:US
Mailing Address - Phone:562-904-4800
Mailing Address - Fax:562-904-4811
Practice Address - Street 1:251 STONEWOOD ST STE 407
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3934
Practice Address - Country:US
Practice Address - Phone:562-904-4800
Practice Address - Fax:562-904-4811
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice