Provider Demographics
NPI:1386049815
Name:LUZVIMINDA V DAYRIT DDS INC.
Entity type:Organization
Organization Name:LUZVIMINDA V DAYRIT DDS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZVIMINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAYRIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-463-6646
Mailing Address - Street 1:12802 FOOTHILL BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-9379
Mailing Address - Country:US
Mailing Address - Phone:909-463-6646
Mailing Address - Fax:909-463-6866
Practice Address - Street 1:12802 FOOTHILL BLVD STE 103
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-9379
Practice Address - Country:US
Practice Address - Phone:909-463-6646
Practice Address - Fax:909-463-6866
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACRED HEART DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-27
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty