Provider Demographics
NPI:1679200919
Name:HERNANDEZ SAAVEDRA, ALVARO RAFAEL (DDS)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:RAFAEL
Last Name:HERNANDEZ SAAVEDRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20739 ELAINE AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-1752
Mailing Address - Country:US
Mailing Address - Phone:702-761-1362
Mailing Address - Fax:
Practice Address - Street 1:16071 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3405
Practice Address - Country:US
Practice Address - Phone:714-536-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1077341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice