Healthcare Provider Details

I. General information

NPI: 1619654563
Provider Name (Legal Business Name): ALEJANDRO DAVID ESCARENO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2465 E PALM CANYON DR STE 605
PALM SPRINGS CA
92264-7003
US

IV. Provider business mailing address

40743 QUEEN CITY ST
INDIO CA
92203-3868
US

V. Phone/Fax

Practice location:
  • Phone: 760-483-9435
  • Fax:
Mailing address:
  • Phone: 760-574-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: