Provider Demographics
NPI:1942582937
Name:YARBER, LENISE N (DDS)
Entity Type:Individual
Prefix:DR
First Name:LENISE
Middle Name:N
Last Name:YARBER
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:PO BOX 6326
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90714-6326
Mailing Address - Country:US
Mailing Address - Phone:310-337-2975
Mailing Address - Fax:310-337-2986
Practice Address - Street 1:8930 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3606
Practice Address - Country:US
Practice Address - Phone:310-337-2975
Practice Address - Fax:310-337-2986
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY500557611223P0221X
CA613931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry