Healthcare Provider Details

I. General information

NPI: 1699280685
Provider Name (Legal Business Name): ZAMBRANO & ALVARADO DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3814 LA SIERRA AVE
RIVERSIDE CA
92505-3528
US

IV. Provider business mailing address

3814 LA SIERRA AVE
RIVERSIDE CA
92505-3528
US

V. Phone/Fax

Practice location:
  • Phone: 951-729-4800
  • Fax:
Mailing address:
  • Phone: 951-729-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FREDDY ZAMBRANO
Title or Position: DENTIST
Credential: DDS
Phone: 951-729-4800