Provider Demographics
NPI:1831286012
Name:UHL, LISA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:E
Last Name:UHL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:E
Other - Last Name:BECK-UHL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5973 ENCINA RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2273
Mailing Address - Country:US
Mailing Address - Phone:805-964-5582
Mailing Address - Fax:
Practice Address - Street 1:5973 ENCINA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2273
Practice Address - Country:US
Practice Address - Phone:805-964-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice