Provider Demographics
NPI:1093074791
Name:ALVARENGA, KAREN VANESSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:VANESSA
Last Name:ALVARENGA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:VANESSA
Other - Last Name:ALVARENGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:11660 CHURCH ST APT 242
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8931
Mailing Address - Country:US
Mailing Address - Phone:909-261-4791
Mailing Address - Fax:
Practice Address - Street 1:8856 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-1365
Practice Address - Country:US
Practice Address - Phone:951-710-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60668122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist