Provider Demographics
NPI:1346584166
Name:XIAOYU LU DDS INC
Entity Type:Organization
Organization Name:XIAOYU LU DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:XIAOYU
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-572-8238
Mailing Address - Street 1:3925 ROSEMEAD BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1933
Mailing Address - Country:US
Mailing Address - Phone:626-572-8238
Mailing Address - Fax:
Practice Address - Street 1:3925 ROSEMEAD BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1933
Practice Address - Country:US
Practice Address - Phone:626-572-8238
Practice Address - Fax:626-288-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty