Provider Demographics
NPI:1437293974
Name:HERRERA, THERESA ALEJANDRINO (DMD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ALEJANDRINO
Last Name:HERRERA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8265 VILLAGE PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-1254
Mailing Address - Country:US
Mailing Address - Phone:925-223-6445
Mailing Address - Fax:925-417-5922
Practice Address - Street 1:8265 VILLAGE PKWY STE D
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-1254
Practice Address - Country:US
Practice Address - Phone:925-223-6445
Practice Address - Fax:925-417-5922
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice