Provider Demographics
NPI:1609294669
Name:DEVIAN, LYNNE MUSULAS (DDS)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:MUSULAS
Last Name:DEVIAN
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 1:18892 J AND J LN
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-2605
Mailing Address - Country:US
Mailing Address - Phone:714-970-1272
Mailing Address - Fax:
Practice Address - Street 1:124 S ORANGE ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1424
Practice Address - Country:US
Practice Address - Phone:714-532-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist