Provider Demographics
NPI:1568920627
Name:LUZ NEYLA DUNLAP DDS INC
Entity Type:Organization
Organization Name:LUZ NEYLA DUNLAP DDS INC
Other - Org Name:LUZ DUNLAP DDS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:NEYLA
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-220-3469
Mailing Address - Street 1:PO BOX 7932
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93031-7932
Mailing Address - Country:US
Mailing Address - Phone:805-220-3469
Mailing Address - Fax:805-889-0092
Practice Address - Street 1:451 W GONZALES RD STE 160
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0724
Practice Address - Country:US
Practice Address - Phone:805-220-3469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1861899627Medicaid