Provider Demographics
NPI:1154493864
Name:LOOMBA, DIPTI C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIPTI
Middle Name:C
Last Name:LOOMBA
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 1:9200 MILLIKEN AVE
Mailing Address - Street 2:APT#10317
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5484
Mailing Address - Country:US
Mailing Address - Phone:310-909-3581
Mailing Address - Fax:
Practice Address - Street 1:1629 S RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-7707
Practice Address - Country:US
Practice Address - Phone:909-421-2225
Practice Address - Fax:909-421-2099
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA548231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice