Provider Demographics
NPI:1033396460
Name:NOGOY, LOURDES N (DENTAL HYGIENIST)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:N
Last Name:NOGOY
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:LOURDES
Other - Middle Name:YAMBAO
Other - Last Name:NERIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3148 CONCORD LN
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60083-8938
Mailing Address - Country:US
Mailing Address - Phone:847-912-4195
Mailing Address - Fax:
Practice Address - Street 1:495 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5908
Practice Address - Country:US
Practice Address - Phone:847-336-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist