Provider Demographics
NPI:1053529834
Name:GALINDO-MAGALLANES, ALEJANDRA CORPUS (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRA
Middle Name:CORPUS
Last Name:GALINDO-MAGALLANES
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 1:619 PALO ALTO DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7320
Mailing Address - Country:US
Mailing Address - Phone:909-534-4424
Mailing Address - Fax:909-884-6377
Practice Address - Street 1:740 W 3RD ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-3212
Practice Address - Country:US
Practice Address - Phone:909-888-3688
Practice Address - Fax:909-884-6377
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4-38286OtherDELTA DENTAL SAN BDO
CAD38286-01Medicaid
CAD38286-02Medicaid