Provider Demographics
NPI:1245795020
Name:ALANIZ, LILLIAM M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LILLIAM
Middle Name:M
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25025 RED MAPLE LN STE 105
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-1137
Mailing Address - Country:US
Mailing Address - Phone:951-924-6370
Mailing Address - Fax:
Practice Address - Street 1:25025 RED MAPLE LN STE 105
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92551-1137
Practice Address - Country:US
Practice Address - Phone:951-924-6370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103350122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist