| Dich Lu Dds Inc | |
|
3620 S Bristol St Ste 103 Santa Ana CA 92704-7314 | |
| (714) 432-0979 | |
| (714) 432-1279 |
| Full Name | Dich Lu Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 3620 S Bristol St Ste 103, Santa Ana, California |
| Authorized Official Name and Position | Dich Lu (OWNER) |
| Authorized Official Contact | 7144320979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dich Lu Dds Inc 3620 S Bristol St Ste 103 Santa Ana CA 92704-7314 Ph: (714) 432-0979 | Dich Lu Dds Inc 3620 S Bristol St Ste 103 Santa Ana CA 92704-7314 Ph: (714) 432-0979 |
| NPI Number | 1326712258 |
|---|---|
| Provider Enumeration Date | 08/04/2021 |
| Last Update Date | 08/24/2021 |
| Medicare PECOS PAC ID | 6709283740 |
|---|---|
| Medicare Enrollment ID | O20210917002823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326712258 | NPI | - | NPPES |
| 1467740076 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Dich Lu |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1467740076 PECOS PAC ID: 6406188457 Enrollment ID: I20211014002439 |
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