Provider Demographics
NPI:1962550137
Name:AQUINO, LOURDES SANTOS (DDS)
Entity type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:SANTOS
Last Name:AQUINO
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 1:14435 SHERMAN WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-6227
Mailing Address - Country:US
Mailing Address - Phone:818-785-7498
Mailing Address - Fax:818-785-7489
Practice Address - Street 1:14435 SHERMAN WAY STE 107
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-6227
Practice Address - Country:US
Practice Address - Phone:818-785-7498
Practice Address - Fax:818-785-7489
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice