Provider Demographics
NPI:1205019049
Name:SHARON T. LU DDS, INC.
Entity Type:Organization
Organization Name:SHARON T. LU DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:TRAN
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-839-8831
Mailing Address - Street 1:2320 S ROBERTSON BLVD
Mailing Address - Street 2:#102
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-2060
Mailing Address - Country:US
Mailing Address - Phone:310-839-8831
Mailing Address - Fax:310-839-6981
Practice Address - Street 1:2320 S ROBERTSON BLVD
Practice Address - Street 2:#102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-2060
Practice Address - Country:US
Practice Address - Phone:310-839-8831
Practice Address - Fax:310-839-6981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53920122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty