Provider Demographics
NPI:1972492890
Name:CHAVEZ ESCOBEDO, ALEXIS (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:CHAVEZ ESCOBEDO
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 1:10767 JAMACHA BLVD SPC 129
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91978-1862
Mailing Address - Country:US
Mailing Address - Phone:619-251-0335
Mailing Address - Fax:
Practice Address - Street 1:10767 JAMACHA BLVD SPC 129
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91978-1862
Practice Address - Country:US
Practice Address - Phone:619-251-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111867122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist