Provider Demographics
NPI:1326247917
Name:LINDBERGH, DAVID PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:LINDBERGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 ROYAL AVE
Mailing Address - Street 2:#3
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4656
Mailing Address - Country:US
Mailing Address - Phone:805-522-3838
Mailing Address - Fax:
Practice Address - Street 1:1975 ROYAL AVE
Practice Address - Street 2:#3
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4656
Practice Address - Country:US
Practice Address - Phone:805-522-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice