Provider Demographics
NPI:1669547659
Name:ONG, LILIAN SHAW (DDS)
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:SHAW
Last Name:ONG
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 1:820 W MERCED AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-4901
Mailing Address - Country:US
Mailing Address - Phone:626-918-3388
Mailing Address - Fax:626-918-3359
Practice Address - Street 1:820 W MERCED AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-4901
Practice Address - Country:US
Practice Address - Phone:626-918-3388
Practice Address - Fax:626-918-3359
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist