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NPI Code Detail

MEDICARE: ALAINA RAE COLLAZO DDS

MEDICARE: ALAINA RAE COLLAZO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry112306CA

General Provider Information

NPI Number : 1598625493
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAINA RAE COLLAZO DDS
Provider Business Mailing Address
First Line : 130 W EL PORTAL
Second Line :
City : SAN CLEMENTE
State : CA
Zip : 92672-4632
Country : US
Telephone Number : 949-498-9088
Fax Number :
Provider Business Practice Location Address
First Line : 362 3RD ST STE 2
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92651-2307
Country : US
Telephone Number : 949-309-7986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2025
Last Update Date : 12/16/2025

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Directions to “ ALAINA RAE COLLAZO DDS” Practice Location

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