Healthcare Provider Details

I. General information

NPI: 1982547550
Provider Name (Legal Business Name): OLEX, A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E 4TH ST STE A
PERRIS CA
92570-2114
US

IV. Provider business mailing address

24017 ORO GRANDE LN
MISSION VIEJO CA
92691-4315
US

V. Phone/Fax

Practice location:
  • Phone: 909-559-5883
  • Fax:
Mailing address:
  • Phone: 909-559-5883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALLISON LYNNAE OLEX
Title or Position: CEO
Credential: DDS
Phone: 909-559-5883