| Loma Linda Univeristy | |
|
Loma Linda University--school Of Dentistry 11092 Anderson Street Loma Linda CA 92354 | |
| (909) 558-4613 | |
| (909) 558-4192 |
| Full Name | Loma Linda Univeristy |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | Loma Linda University--school Of Dentistry, Loma Linda, California |
| Authorized Official Name and Position | Rodney Dale Neal (VICE PRESIDENT) |
| Authorized Official Contact | 9095584543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loma Linda Univeristy Loma Linda University--school Of Dentistry 11092 Anderson Street Loma Linda CA 92354 Ph: (909) 558-4613 | Loma Linda Univeristy Loma Linda University--school Of Dentistry 11092 Anderson Street Loma Linda CA 92354 Ph: (909) 558-4613 |
| NPI Number | 1124185194 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 03/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124185194 | NPI | - | NPPES |
| G02000-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 2043 (California) | Primary |
Dental Faculty Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25455 Barton Road, Suite 203b, Loma Linda, CA 92354 Phone: 909-558-6468 Fax: 909-558-6469 | |
Loma Linda University Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11092 Anderson Street, Loma Linda, CA 92354 Phone: 909-558-4613 Fax: 909-558-4192 | |
Loma Linda University Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11092 Anderson Street, Room 1147, Loma Linda, CA 92350 Phone: 909-558-4611 Fax: 909-558-0106 | |
Jino Park Dds Dental Corporation Dental Clinic Medicare: Medicare Enrolled Practice Location: 24950 Redlands Blvd Ste B, Loma Linda, CA 92354 Phone: 909-478-9777 Fax: 909-478-9526 | |
Shevanthi Johnson Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11285 Mountain View Ave Ste H-32, Loma Linda, CA 92354 Phone: 909-796-6447 | |
Loma Linda University School Of Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24860 Taylor St, Loma Linda, CA 92354 Phone: 909-558-4613 Fax: 909-558-4192 |