Provider Demographics
NPI:1831258904
Name:LOTT, LINDA D (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:D
Last Name:LOTT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:PO BOX 36488
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-0488
Mailing Address - Country:US
Mailing Address - Phone:323-937-0547
Mailing Address - Fax:323-221-6747
Practice Address - Street 1:28040 DOROTHY DR
Practice Address - Street 2:SUITE #201
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4914
Practice Address - Country:US
Practice Address - Phone:818-889-2061
Practice Address - Fax:818-889-2055
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA245721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry