Provider Demographics
NPI:1255673083
Name:MIZRAJI, ALEJANDRO GUILLERMO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:GUILLERMO
Last Name:MIZRAJI
Suffix:
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 1:2807 LOMA VISTA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1500
Mailing Address - Country:US
Mailing Address - Phone:805-653-5606
Mailing Address - Fax:805-653-0807
Practice Address - Street 1:2807 LOMA VISTA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1500
Practice Address - Country:US
Practice Address - Phone:805-653-5606
Practice Address - Fax:805-653-0807
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA325941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice