Provider Demographics
NPI:1609086966
Name:ALVARENGA, DASIY PATRICIA (DDS)
Entity Type:Individual
Prefix:
First Name:DASIY
Middle Name:PATRICIA
Last Name:ALVARENGA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 W LINCOLN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-6730
Mailing Address - Country:US
Mailing Address - Phone:714-399-0487
Mailing Address - Fax:
Practice Address - Street 1:1814 W LINCOLN AVE STE B
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6730
Practice Address - Country:US
Practice Address - Phone:714-399-0487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice