Provider Demographics
NPI:1336352103
Name:UYSINGCO, LOURDES (DMD)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:UYSINGCO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 N AVALON BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744
Mailing Address - Country:US
Mailing Address - Phone:310-834-5525
Mailing Address - Fax:310-834-5540
Practice Address - Street 1:934 N AVALON BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744
Practice Address - Country:US
Practice Address - Phone:310-834-5525
Practice Address - Fax:310-834-5540
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31410122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist