Provider Demographics
NPI:1558418582
Name:STOJIC, LILLIANA LJILJANA (DDS)
Entity Type:Individual
Prefix:MS
First Name:LILLIANA
Middle Name:LJILJANA
Last Name:STOJIC
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2748
Mailing Address - Country:US
Mailing Address - Phone:916-487-5147
Mailing Address - Fax:916-487-7803
Practice Address - Street 1:2821 EASTERN AVE STE 4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5445
Practice Address - Country:US
Practice Address - Phone:916-487-5147
Practice Address - Fax:916-487-7803
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA459801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3548658OtherCA.DRIVER LICENSE