Provider Demographics
NPI:1821103169
Name:LAY, GILBERT KHIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:KHIN
Last Name:LAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13922 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-1725
Mailing Address - Country:US
Mailing Address - Phone:562-926-7025
Mailing Address - Fax:562-926-0956
Practice Address - Street 1:13922 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1725
Practice Address - Country:US
Practice Address - Phone:562-926-7025
Practice Address - Fax:562-926-0956
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice