Provider Demographics
NPI:1356595227
Name:LAMBOY AND RUBIO, DDS, PA.
Entity type:Organization
Organization Name:LAMBOY AND RUBIO, DDS, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:AYALA RUBIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-626-7555
Mailing Address - Street 1:405 E DIXIE DR STE K
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-6827
Mailing Address - Country:US
Mailing Address - Phone:336-626-7555
Mailing Address - Fax:
Practice Address - Street 1:405 E DIXIE DR STE K
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6827
Practice Address - Country:US
Practice Address - Phone:336-626-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAMBOY AND RUBIO, DDS, PA.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7892122300000X
NC81031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905125Medicaid