Provider Demographics
NPI:1679634299
Name:NAJERA, ALFONSO JOSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALFONSO
Middle Name:JOSE
Last Name:NAJERA
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 1:6505 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-2521
Mailing Address - Country:US
Mailing Address - Phone:323-771-9161
Mailing Address - Fax:323-771-3460
Practice Address - Street 1:6505 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-2521
Practice Address - Country:US
Practice Address - Phone:323-771-9161
Practice Address - Fax:323-771-3460
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA260961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice