Doctor Name: | DR. JONATHAN H LO |
NPI Number: | 1063622371 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S |
License Number: | 54926 |
Business Practice Address: | 550 Deep Valley Dr Suite 345 Rolling Hills Estates, CA - 902743664 |
Business Phone Number: | 3103774551 |
Business Fax Number: | 3105416042 |
Mailing Address: | 550 Deep Valley Dr, Suite 345 ROLLING HILLS ESTATES |
State: | CA |
Postal Code: | 902743664 |
Phone Number: | 3103774551 |
Fax Number: | 3105416042 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 01/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 54926 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |