Provider Demographics
NPI:1477725034
Name:ALONSAGAY-DEL CAMPO, SHELLAINE (DMD)
Entity Type:Individual
Prefix:
First Name:SHELLAINE
Middle Name:
Last Name:ALONSAGAY-DEL CAMPO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SHELLAINE
Other - Middle Name:ALONSAGAY
Other - Last Name:DEL CAMPO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27725 SANTA MARGARITA PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27725 SANTA MARGARITA PKWY STE 270
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6708
Practice Address - Country:US
Practice Address - Phone:949-951-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice