Provider Demographics
NPI:1558537811
Name:LINGAD, ABIGAIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:
Last Name:LINGAD
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 1:1485 EL CAMINO REAL
Mailing Address - Street 2:#205
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3932
Mailing Address - Country:US
Mailing Address - Phone:650-591-5550
Mailing Address - Fax:650-595-9911
Practice Address - Street 1:1485 EL CAMINO REAL
Practice Address - Street 2:#205
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3932
Practice Address - Country:US
Practice Address - Phone:650-591-5550
Practice Address - Fax:650-595-9911
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49367122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA49367OtherSTATE LICENSE