Provider Demographics
NPI:1710179387
Name:LIPUMANO-SANCHEZ, LULETTE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LULETTE
Middle Name:
Last Name:LIPUMANO-SANCHEZ
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 1:6223 TILLAMOOK DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-4752
Mailing Address - Country:US
Mailing Address - Phone:408-655-3987
Mailing Address - Fax:
Practice Address - Street 1:6223 TILLAMOOK DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-4752
Practice Address - Country:US
Practice Address - Phone:408-655-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50950122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist