Provider Demographics
NPI:1326000522
Name:VILLASENOR, ALEJANDRA (DDS MS)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:VILLASENOR
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4253 POTOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205
Mailing Address - Country:US
Mailing Address - Phone:214-696-3082
Mailing Address - Fax:214-696-4607
Practice Address - Street 1:8325 WALNUT HILL LANE
Practice Address - Street 2:STE 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-696-3082
Practice Address - Fax:214-696-4607
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179701223P0221X
CO69741223P0221X
MD131291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry