Provider Demographics
NPI:1992830806
Name:AMBAS, STANLEY LINGOY (DMD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:LINGOY
Last Name:AMBAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 N VERMONT AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6307
Mailing Address - Country:US
Mailing Address - Phone:323-953-9183
Mailing Address - Fax:323-664-9844
Practice Address - Street 1:1321 N VERMONT AVENUE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6307
Practice Address - Country:US
Practice Address - Phone:323-953-9183
Practice Address - Fax:323-664-9844
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist