| The Emergency Dental Center Of Hayward Practice Of Maria Alarcon Dds | |
|
19682 Hesperian Blvd Second Floor Suite #208 Hayward CA 94541-4752 | |
| (510) 253-2350 | |
| (510) 255-2161 |
| Full Name | The Emergency Dental Center Of Hayward Practice Of Maria Alarcon Dds |
|---|---|
| Speciality | Clinic/Center |
| Location | 19682 Hesperian Blvd, Hayward, California |
| Authorized Official Name and Position | Maria T Alarcon (PRESIDENT/OWNER) |
| Authorized Official Contact | 5102532350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Emergency Dental Center Of Hayward Practice Of Maria Alarcon Dds 19682 Hesperian Blvd Second Floor Suite #208 Hayward CA 94541-4752 Ph: (510) 253-2350 | The Emergency Dental Center Of Hayward Practice Of Maria Alarcon Dds 19682 Hesperian Blvd Second Floor Suite #208 Hayward CA 94541-4752 Ph: (510) 253-2350 |
| NPI Number | 1467955369 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 04/14/2021 |
| Medicare PECOS PAC ID | 0941564736 |
|---|---|
| Medicare Enrollment ID | O20190219001910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467955369 | NPI | - | NPPES |
| 1518066117 | Medicaid | CA | |
| 1598873853 | Medicaid | CA | |
| 1407385123 | Medicaid | CA | |
| 1427198134 | Medicaid | CA | |
| 1346576659 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 135306 (California) | Secondary |
| 122300000X | Dentist | 34647 (California) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Maria T Alarcon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1427198134 PECOS PAC ID: 8022372820 Enrollment ID: I20190222000445 |
| Provider Name | Vilian M Kossev |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1407385123 PECOS PAC ID: 2769746304 Enrollment ID: I20190222000906 |
| Provider Name | Allen H Dare |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1346576659 PECOS PAC ID: 3577827278 Enrollment ID: I20190225001574 |
| Provider Name | Nikolas M Stathopoulos |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1144594441 PECOS PAC ID: 9638417538 Enrollment ID: I20190703001957 |
| Provider Name | Elise J Daggs-marshall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518066117 PECOS PAC ID: 7911261557 Enrollment ID: I20190802001586 |
| Provider Name | Robert V Wick |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598873853 PECOS PAC ID: 3577827112 Enrollment ID: I20190807000907 |
| Provider Name | Jiachang Zhang |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578649604 PECOS PAC ID: 8325478175 Enrollment ID: I20200420001733 |
| Provider Name | Javier Lopez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609278076 PECOS PAC ID: 6507100682 Enrollment ID: I20210528000394 |
| Provider Name | Jeremy Brent Owyoung |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225262652 PECOS PAC ID: 8628371952 Enrollment ID: I20210528001651 |
| Provider Name | Suhani K Shah |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1184939092 PECOS PAC ID: 2961800925 Enrollment ID: I20211006001757 |
| Provider Name | Filippo Cangini |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205049137 PECOS PAC ID: 1951617570 Enrollment ID: I20211008001632 |
| Provider Name | Robert V Wick |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598873853 PECOS PAC ID: 3577827112 Enrollment ID: I20211111001276 |
| Provider Name | Stephanie Alarcon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053954156 PECOS PAC ID: 8022403807 Enrollment ID: I20220314000797 |
| Provider Name | Ma Rosario Gutierrez Exconde |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922196559 PECOS PAC ID: 3375938962 Enrollment ID: I20220317001221 |
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