Provider Demographics
NPI:1639275456
Name:LAMBRIDIS AND MAR DENTAL CORPORATION
Entity Type:Organization
Organization Name:LAMBRIDIS AND MAR DENTAL CORPORATION
Other - Org Name:CAMARILLO DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBRIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-388-9110
Mailing Address - Street 1:2860 MICHELLE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1009
Mailing Address - Country:US
Mailing Address - Phone:714-508-3600
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:2380 LAS POSAS RD
Practice Address - Street 2:A & D
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3456
Practice Address - Country:US
Practice Address - Phone:805-388-9110
Practice Address - Fax:805-987-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433001223E0200X
CA511991223G0001X
CA542631223G0001X
CA438601223P0300X
CA374401223S0112X
CA513261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty