Provider Demographics
NPI:1144457268
Name:LAVORINI-DOYLE, CASSIDY MIGAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CASSIDY
Middle Name:MIGAN
Last Name:LAVORINI-DOYLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MANDANA BLVD
Mailing Address - Street 2:APT 311
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2260
Mailing Address - Country:US
Mailing Address - Phone:925-963-3660
Mailing Address - Fax:
Practice Address - Street 1:363 15TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3303
Practice Address - Country:US
Practice Address - Phone:510-444-4334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA623671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery