Provider Demographics
NPI:1770133944
Name:ALPERT, TODD HENRY JR (DDS)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:HENRY
Last Name:ALPERT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44100 TOWN CENTER WAY STE A3
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2763
Mailing Address - Country:US
Mailing Address - Phone:503-405-1155
Mailing Address - Fax:
Practice Address - Street 1:44100 TOWN CENTER WAY STE A3
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2763
Practice Address - Country:US
Practice Address - Phone:503-405-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD111571223G0001X
CA104540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice