Provider Demographics
NPI:1255690723
Name:ARWIN, LYDIA D (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:D
Last Name:ARWIN
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 1:23741 LA PALMA AVE
Mailing Address - Street 2:SUITE #C
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-5539
Mailing Address - Country:US
Mailing Address - Phone:714-692-5001
Mailing Address - Fax:714-692-5003
Practice Address - Street 1:23741 LA PALMA AVE
Practice Address - Street 2:SUITE #C
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-5539
Practice Address - Country:US
Practice Address - Phone:714-692-5001
Practice Address - Fax:714-692-5003
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA386421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice