Provider Demographics
NPI:1902657810
Name:APEX DENTAL GROUP OF DR KRISTINA FERNANDEZ
Entity Type:Organization
Organization Name:APEX DENTAL GROUP OF DR KRISTINA FERNANDEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-915-5292
Mailing Address - Street 1:13390 LARKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-3205
Mailing Address - Country:US
Mailing Address - Phone:951-529-9762
Mailing Address - Fax:
Practice Address - Street 1:79800 HIGHWAY 111 STE 109
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-6003
Practice Address - Country:US
Practice Address - Phone:760-775-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty