Provider Demographics
NPI:1467502815
Name:JAUREGUI, HECTOR MANUEL (DDS)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:MANUEL
Last Name:JAUREGUI
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 1:470 N LOS ROBLES AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1302
Mailing Address - Country:US
Mailing Address - Phone:626-564-4330
Mailing Address - Fax:626-568-2925
Practice Address - Street 1:470 N LOS ROBLES AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1302
Practice Address - Country:US
Practice Address - Phone:626-564-4330
Practice Address - Fax:626-568-2925
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice