1992258875 NPI number — DR. JEFFREY ALEXANDER FIGUEROA DDS

Table of content: DR. JEFFREY ALEXANDER FIGUEROA DDS (NPI 1992258875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992258875 NPI number — DR. JEFFREY ALEXANDER FIGUEROA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIGUEROA
Provider First Name:
JEFFREY
Provider Middle Name:
ALEXANDER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992258875
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3297 ARLINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE NUMBER 101
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92506-3249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-683-6055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2016

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: 122300000X , with the licence number:  100557 , 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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