Provider Demographics
NPI:1619122561
Name:ALAMEDA COUNTY OFFICE OF DENTAL HEALTH
Entity Type:Organization
Organization Name:ALAMEDA COUNTY OFFICE OF DENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DENTAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AURORA ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO MAMURI
Authorized Official - Suffix:
Authorized Official - Credentials:RDA
Authorized Official - Phone:510-912-9093
Mailing Address - Street 1:1100 SAN LEANDRO BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-1670
Mailing Address - Country:US
Mailing Address - Phone:510-208-5910
Mailing Address - Fax:
Practice Address - Street 1:1100 SAN LEANDRO BLVD STE 400
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1670
Practice Address - Country:US
Practice Address - Phone:510-208-5910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAMEDA COUNTY PUBLIC HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-19
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No251K00000XAgenciesPublic Health or Welfare