Provider Demographics
NPI:1104937010
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:MISS
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:678-595-6470
Mailing Address - Street 1:100 WESTWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262
Mailing Address - Country:US
Mailing Address - Phone:336-885-5437
Mailing Address - Fax:336-885-5454
Practice Address - Street 1:100 WESTWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262
Practice Address - Country:US
Practice Address - Phone:336-885-5437
Practice Address - Fax:336-885-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7892122300000X
NC81031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902740Medicaid