Provider Demographics
NPI:1699882183
Name:REGALADO, ALOIS LAGASCA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALOIS
Middle Name:LAGASCA
Last Name:REGALADO
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 1:2417 WARM SPRINGS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356
Mailing Address - Country:US
Mailing Address - Phone:209-572-1722
Mailing Address - Fax:209-572-1725
Practice Address - Street 1:1801 H STREET
Practice Address - Street 2:SUITE A7
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354
Practice Address - Country:US
Practice Address - Phone:209-572-1722
Practice Address - Fax:209-572-1725
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD48172OtherDENTICAL
CAD48172OtherDENTICAL