Provider Demographics
NPI:1922526573
Name:EDWARD W. LEW DMD INC.
Entity Type:Organization
Organization Name:EDWARD W. LEW DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:WESTWEALTH
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:562-925-7436
Mailing Address - Street 1:17024 CLARK AVE SUITE C
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5700
Mailing Address - Country:US
Mailing Address - Phone:562-925-7436
Mailing Address - Fax:
Practice Address - Street 1:17024 CLARK AVE SUITE C
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706
Practice Address - Country:US
Practice Address - Phone:562-925-7436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53083122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty