Provider Demographics
NPI:1740991694
Name:ALVARADO BAIRES, ELBA CECILIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ELBA
Middle Name:CECILIA
Last Name:ALVARADO BAIRES
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 1:1166 NORCREST ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92878-3643
Mailing Address - Country:US
Mailing Address - Phone:951-336-6030
Mailing Address - Fax:
Practice Address - Street 1:1166 NORCREST ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92878-3643
Practice Address - Country:US
Practice Address - Phone:951-336-6028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1084061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice