Provider Demographics
NPI:1912155276
Name:SUBIDO, ANDREW SALVADOR (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SALVADOR
Last Name:SUBIDO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-2035
Mailing Address - Country:US
Mailing Address - Phone:415-924-7900
Mailing Address - Fax:415-924-7901
Practice Address - Street 1:428 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-2035
Practice Address - Country:US
Practice Address - Phone:415-924-7900
Practice Address - Fax:415-924-7901
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA574681223G0001X
CA19551223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0004XDental ProvidersDentistDental Anesthesiology