Provider Demographics
NPI:1306039169
Name:LU, SHELDON XIAOCHEN (DMD)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:XIAOCHEN
Last Name:LU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W TOWN AND COUNTRY RD STE 46
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4667
Mailing Address - Country:US
Mailing Address - Phone:714-835-4441
Mailing Address - Fax:714-835-0188
Practice Address - Street 1:1111 W TOWN AND COUNTRY RD STE 46
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4667
Practice Address - Country:US
Practice Address - Phone:714-835-4441
Practice Address - Fax:714-835-0188
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA647651223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics