Provider Demographics
NPI:1427450121
Name:SAFAR, LORI ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:LORI ANN
Middle Name:
Last Name:SAFAR
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 1:13790 ROSECROFT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-5106
Mailing Address - Country:US
Mailing Address - Phone:858-735-5916
Mailing Address - Fax:
Practice Address - Street 1:4765 CARMEL MOUNTAIN RD STE 206
Practice Address - Street 2:206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6657
Practice Address - Country:US
Practice Address - Phone:858-481-8688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice