Provider Demographics
NPI:1811198476
Name:NAMSINH, LILY ANN
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:ANN
Last Name:NAMSINH
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LILY
Other - Middle Name:A
Other - Last Name:NAMSINH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13945 HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4012
Mailing Address - Country:US
Mailing Address - Phone:714-554-7123
Mailing Address - Fax:714-554-3273
Practice Address - Street 1:13945 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4012
Practice Address - Country:US
Practice Address - Phone:714-554-7123
Practice Address - Fax:714-554-3273
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA30208OtherDENTICAL PROVIDER
CA100007381Medicaid