Provider Demographics
NPI:1841857042
Name:ALVAREZ ALVAREZ, DANIELA TRINIDAD (DDS)
Entity type:Individual
Prefix:MS
First Name:DANIELA
Middle Name:TRINIDAD
Last Name:ALVAREZ ALVAREZ
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 1:4468 HAMMOCKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454
Mailing Address - Country:US
Mailing Address - Phone:585-957-3457
Mailing Address - Fax:
Practice Address - Street 1:625 ELMWOOD AVE.
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-275-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0001001223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice