Provider Demographics
NPI:1689389926
Name:RIOS LINARES, ERNESTO ALFONSO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:ALFONSO
Last Name:RIOS LINARES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERNESTO
Other - Middle Name:A
Other - Last Name:RIOS LINARES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR ERNESTO RIOS
Mailing Address - Street 1:12120 SATICOY ST STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-3055
Mailing Address - Country:US
Mailing Address - Phone:818-255-2224
Mailing Address - Fax:818-255-2223
Practice Address - Street 1:12120 SATICOY ST STE C
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-3055
Practice Address - Country:US
Practice Address - Phone:818-255-2244
Practice Address - Fax:818-255-2223
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1084181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice