Healthcare Provider Details

I. General information

NPI: 1366698268
Provider Name (Legal Business Name): LULETTE ALVERO MERCADO D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 W OLIVE AVE STE C
MERCED CA
95348-2421
US

IV. Provider business mailing address

840 W OLIVE AVE STE C
MERCED CA
95348-2421
US

V. Phone/Fax

Practice location:
  • Phone: 209-777-9508
  • Fax:
Mailing address:
  • Phone: 209-777-9508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: