Provider Demographics
NPI:1831075787
Name:ALVARADO, AMANDA ANN (DDS)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANN
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 CEDAREDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1537
Mailing Address - Country:US
Mailing Address - Phone:323-333-3667
Mailing Address - Fax:
Practice Address - Street 1:2235 E GARVEY AVE N
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1540
Practice Address - Country:US
Practice Address - Phone:626-412-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS111814122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist