Provider Demographics
NPI:1003222613
Name:SANTOS, ALEXANDER X (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:SANTOS
Suffix:X
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 1:4183 CHINO HILLS PKWY STE H
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3781
Mailing Address - Country:US
Mailing Address - Phone:909-393-5300
Mailing Address - Fax:
Practice Address - Street 1:4183 CHINO HILLS PKWY STE H
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3781
Practice Address - Country:US
Practice Address - Phone:909-393-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA359871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice