Provider Demographics
NPI:1578905121
Name:LOFTUS, ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:MATESSINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3116 BOSTONIAN DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-4238
Mailing Address - Country:US
Mailing Address - Phone:916-837-1761
Mailing Address - Fax:
Practice Address - Street 1:6413 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-4022
Practice Address - Country:US
Practice Address - Phone:562-938-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA624711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice