Provider Demographics
NPI:1366023335
Name:LUZVIMINDA V DAYRIT DDS INC
Entity Type:Organization
Organization Name:LUZVIMINDA V DAYRIT DDS INC
Other - Org Name:PAVILION SMILE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUZVIMINDA
Authorized Official - Middle Name:V
Authorized Official - Last Name:DAYRIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-463-6646
Mailing Address - Street 1:5680 GRATA VISTA CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-2350
Mailing Address - Country:US
Mailing Address - Phone:951-756-4780
Mailing Address - Fax:
Practice Address - Street 1:2094 W REDLANDS BLVD STE F
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6266
Practice Address - Country:US
Practice Address - Phone:909-792-0500
Practice Address - Fax:909-792-0598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAVILION SMILE DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-20
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental