Provider Demographics
NPI:1689964694
Name:ALANIZ, ROSA M (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:M
Last Name:ALANIZ
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 1:5835 N I ST
Mailing Address - Street 2:5835 NORTH I STREET
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-2567
Mailing Address - Country:US
Mailing Address - Phone:951-415-9483
Mailing Address - Fax:
Practice Address - Street 1:5835 N I ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-2567
Practice Address - Country:US
Practice Address - Phone:951-415-9483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist