MEDICARE: DR. JEFFREY ALEXANDER FIGUEROA 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
1	122300000X	Dentist	100557	CA

General Provider Information

NPI Number	:	1992258875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ALEXANDER FIGUEROA DDS

Provider Business Mailing Address
First Line	:	11852 MOUNT VERNON AVE
Second Line	:	APT J362
City	:	GRAND TERRACE
State	:	CA
Zip	:	92313-8207
Country	:	US
Telephone Number	:	323-352-6606
Fax Number	:

Provider Business Practice Location Address
First Line	:	3297 ARLINGTON AVE
Second Line	:	SUITE NUMBER 101
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-3249
Country	:	US
Telephone Number	:	951-683-6055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2016
Last Update Date	:	07/27/2016

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