Provider Demographics
NPI:1710615414
Name:TENDENCIA, ALMA MOCON (RDA)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:MOCON
Last Name:TENDENCIA
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10812 19TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-5153
Mailing Address - Country:US
Mailing Address - Phone:425-338-5414
Mailing Address - Fax:425-338-5744
Practice Address - Street 1:10812 19TH AVE SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-5153
Practice Address - Country:US
Practice Address - Phone:425-338-5414
Practice Address - Fax:425-338-5744
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD160052314126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant