Provider Demographics
NPI:1639294978
Name:SILAGAN-FERNANDEZ, LYNGLADEN (DDS)
Entity Type:Individual
Prefix:
First Name:LYNGLADEN
Middle Name:
Last Name:SILAGAN-FERNANDEZ
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 1:10881 SINCLARE CIR
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6549
Mailing Address - Country:US
Mailing Address - Phone:909-556-8149
Mailing Address - Fax:
Practice Address - Street 1:10881 SINCLARE CIR
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-6549
Practice Address - Country:US
Practice Address - Phone:909-556-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist