Provider Demographics
NPI:1265447668
Name:ENANO, LILINDA CRUZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILINDA
Middle Name:CRUZ
Last Name:ENANO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 BONITA RD
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902
Mailing Address - Country:US
Mailing Address - Phone:619-475-4226
Mailing Address - Fax:619-475-1560
Practice Address - Street 1:4144 BONITA RD
Practice Address - Street 2:
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902
Practice Address - Country:US
Practice Address - Phone:619-475-4226
Practice Address - Fax:619-475-1560
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA508586OtherMEDICAL IDENTICAL
CA686971OtherUNITED CONCORDIA