Provider Demographics
NPI:1730743550
Name:ALVAREZ, DANIELA (DMD)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 LIBERTY PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-9376
Mailing Address - Country:US
Mailing Address - Phone:239-216-7073
Mailing Address - Fax:
Practice Address - Street 1:855 JUNIPER ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1364
Practice Address - Country:US
Practice Address - Phone:239-216-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24670122300000X
GADN122848122300000X
IL019032323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist