Provider Demographics
NPI:1811109630
Name:LOMBARDO, RICHARD J I (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:LOMBARDO
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:J
Other - Last Name:LOMBARDO
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:9 MANU TRL
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-3306
Mailing Address - Country:US
Mailing Address - Phone:973-347-6866
Mailing Address - Fax:973-347-6866
Practice Address - Street 1:191 US HIGHWAY 206
Practice Address - Street 2:SUITE 1
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9002
Practice Address - Country:US
Practice Address - Phone:973-584-5550
Practice Address - Fax:973-584-4221
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100866300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist