Provider Demographics
NPI:1992046304
Name:D. ALVARENGA, DDS, INC.
Entity type:Organization
Organization Name:D. ALVARENGA, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:ALVARENGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-309-2734
Mailing Address - Street 1:169 GREENFIELD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614
Mailing Address - Country:US
Mailing Address - Phone:213-309-2734
Mailing Address - Fax:
Practice Address - Street 1:23772 MERCURY RD.
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630
Practice Address - Country:US
Practice Address - Phone:213-309-2734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty