Provider Demographics
NPI:1164570594
Name:ERNESTINA AVALOS-FIGUEROA DDS. APC
Entity Type:Organization
Organization Name:ERNESTINA AVALOS-FIGUEROA DDS. APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVALOS-FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-831-5511
Mailing Address - Street 1:15 MAREBLU
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3015
Mailing Address - Country:US
Mailing Address - Phone:949-831-5511
Mailing Address - Fax:949-831-6624
Practice Address - Street 1:15 MAREBLU
Practice Address - Street 2:SUITE 360
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3015
Practice Address - Country:US
Practice Address - Phone:949-831-5511
Practice Address - Fax:949-831-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty