Provider Demographics
NPI:1477074805
Name:LANGE, JOSHUA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:R
Last Name:LANGE
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 1:32664 RITCHART CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3375
Mailing Address - Country:US
Mailing Address - Phone:661-972-6923
Mailing Address - Fax:
Practice Address - Street 1:26810 YNEZ CT STE E
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4691
Practice Address - Country:US
Practice Address - Phone:209-533-9630
Practice Address - Fax:951-695-2223
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1015181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice