Provider Demographics
NPI:1801118567
Name:OLEX, ALLISON (DDS)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:OLEX
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 1:25596 ALICIA PKWY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5309
Mailing Address - Country:US
Mailing Address - Phone:949-951-7645
Mailing Address - Fax:
Practice Address - Street 1:905 CALLE AMANECER
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6274
Practice Address - Country:US
Practice Address - Phone:949-429-6910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54562122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist