1841431384 NPI number — DR. LOURDES VERONICA HAWKINS DDS

Table of content: DR. LOURDES VERONICA HAWKINS DDS (NPI 1841431384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841431384 NPI number — DR. LOURDES VERONICA HAWKINS DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAWKINS
Provider First Name:
LOURDES
Provider Middle Name:
VERONICA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAWKINS
Provider Other First Name:
VERONICA
Provider Other Middle Name:
L.P.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841431384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3814 LA SIERRA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVERSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92505-3528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-351-9000
Provider Business Mailing Address Fax Number:
951-351-1149

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3814 LA SIERRA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92505-3528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-351-9000
Provider Business Practice Location Address Fax Number:
951-351-1149
Provider Enumeration Date:
03/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  38947 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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