Provider Demographics
NPI:1669495180
Name:EMERY, ALYSON DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALYSON
Middle Name:DEAN
Last Name:EMERY
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 1:3840 WOODRUFF AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2149
Mailing Address - Country:US
Mailing Address - Phone:562-421-9361
Mailing Address - Fax:562-421-5821
Practice Address - Street 1:3840 WOODRUFF AVE STE 208
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2149
Practice Address - Country:US
Practice Address - Phone:562-421-9361
Practice Address - Fax:562-421-5821
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33755122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB33755-01OtherDENTICAL