Provider Demographics
NPI:1972970028
Name:BORNA, LINDA (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:BORNA
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 1:420 W BASELINE RD STE B
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1621
Mailing Address - Country:US
Mailing Address - Phone:323-333-3325
Mailing Address - Fax:
Practice Address - Street 1:420 W BASELINE RD STE B
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1621
Practice Address - Country:US
Practice Address - Phone:909-625-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice