Provider Demographics
NPI:1023407038
Name:JOHN D LAJOY DENTAL GROUP
Entity type:Organization
Organization Name:JOHN D LAJOY DENTAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAJOY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-362-0435
Mailing Address - Street 1:13867 FOOTHILL BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3029
Mailing Address - Country:US
Mailing Address - Phone:818-362-0435
Mailing Address - Fax:818-362-6305
Practice Address - Street 1:13867 FOOTHILL BLVD STE 114
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-3029
Practice Address - Country:US
Practice Address - Phone:818-362-0435
Practice Address - Fax:818-362-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty