Provider Demographics
NPI:1467955369
Name:MARIA T ALARCON DDS DENTAL CORPORATION
Entity Type:Organization
Organization Name:MARIA T ALARCON DDS DENTAL CORPORATION
Other - Org Name:THE EMERGENCY DENTAL CENTER OF HAYWARD PRACTICE OF MARIA ALARCON DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-253-2350
Mailing Address - Street 1:19682 HESPERIAN BLVD
Mailing Address - Street 2:SECOND FLOOR SUITE #208
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4752
Mailing Address - Country:US
Mailing Address - Phone:510-253-2350
Mailing Address - Fax:510-255-2161
Practice Address - Street 1:19682 HESPERIAN BLVD
Practice Address - Street 2:SECOND FLOOR SUITE #208
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4752
Practice Address - Country:US
Practice Address - Phone:510-253-2350
Practice Address - Fax:510-255-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135306122300000X
CA34647122300000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1518066117Medicaid
CA1598873853Medicaid
CA1407385123Medicaid
CA1427198134Medicaid
CA1346576659Medicaid