Provider Demographics
NPI:1679311518
Name:ALMORA, ANDRES ALEJANDRO (DDS)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:ALEJANDRO
Last Name:ALMORA
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 1:16840 MCCORMICK ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1022
Mailing Address - Country:US
Mailing Address - Phone:818-438-6878
Mailing Address - Fax:
Practice Address - Street 1:14649 VICTORY BLVD STE 24
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-4101
Practice Address - Country:US
Practice Address - Phone:818-779-1663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1101301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice