Provider Demographics
NPI:1447654462
Name:ALPEZ, RICARDO (DDS)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:ALPEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4648 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3926
Mailing Address - Country:US
Mailing Address - Phone:909-628-6701
Mailing Address - Fax:909-628-6704
Practice Address - Street 1:4648 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3926
Practice Address - Country:US
Practice Address - Phone:909-628-6701
Practice Address - Fax:909-628-6704
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA409111223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice