Provider Demographics
NPI:1831130152
Name:FRIEDMAN, LAUREN R (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:R
Last Name:FRIEDMAN
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 1:2355 WESTWOOD BLVD # 718
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2109
Mailing Address - Country:US
Mailing Address - Phone:310-418-7788
Mailing Address - Fax:800-801-8730
Practice Address - Street 1:2355 WESTWOOD BLVD # 718
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2109
Practice Address - Country:US
Practice Address - Phone:310-418-7788
Practice Address - Fax:800-801-8730
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB266391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB-26639-01Medicaid