Provider Demographics
NPI:1134355969
Name:D'ALESSANDRO, MA DEL CONSUELO (DDS)
Entity type:Individual
Prefix:DR
First Name:MA DEL CONSUELO
Middle Name:
Last Name:D'ALESSANDRO
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 1:1600 SAN FERNANDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-3115
Mailing Address - Country:US
Mailing Address - Phone:818-365-8086
Mailing Address - Fax:
Practice Address - Street 1:3945 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2440
Practice Address - Country:US
Practice Address - Phone:323-265-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice