Provider Demographics
NPI:1841431384
Name:HAWKINS, LOURDES VERONICA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:VERONICA
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:LP
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3814 LA SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3528
Mailing Address - Country:US
Mailing Address - Phone:951-351-9000
Mailing Address - Fax:951-351-1149
Practice Address - Street 1:3814 LA SIERRA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3528
Practice Address - Country:US
Practice Address - Phone:951-351-9000
Practice Address - Fax:951-351-1149
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice