Provider Demographics
NPI:1902023377
Name:ALZONA, CRISANTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRISANTA
Middle Name:
Last Name:ALZONA
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 1:26137 LA PAZ RD
Mailing Address - Street 2:SUITE #270
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5319
Mailing Address - Country:US
Mailing Address - Phone:949-581-1900
Mailing Address - Fax:949-581-5454
Practice Address - Street 1:26137 LA PAZ RD
Practice Address - Street 2:SUITE #270
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5319
Practice Address - Country:US
Practice Address - Phone:949-581-1900
Practice Address - Fax:949-581-5454
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice