Healthcare Provider Details

I. General information

NPI: 1386821031
Provider Name (Legal Business Name): JOSE IGNACIO ALAMO JR. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4918 ILLINOIS AVE NW
WASHINGTON DC
20011-4528
US

IV. Provider business mailing address

4918 ILLINOIS AVE NW
WASHINGTON DC
20011-4528
US

V. Phone/Fax

Practice location:
  • Phone: 210-378-1883
  • Fax:
Mailing address:
  • Phone: 210-378-1883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number053738
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number17926
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number24068
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: