MEDICARE: ELIZABETH LOFTUS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	62471	CA

General Provider Information

NPI Number	:	1578905121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LOFTUS DDS

Provider Business Mailing Address
First Line	:	3116 BOSTONIAN DR
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-4238
Country	:	US
Telephone Number	:	916-837-1761
Fax Number	:

Provider Business Practice Location Address
First Line	:	6413 E SPRING ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-4022
Country	:	US
Telephone Number	:	562-938-8388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	04/04/2023

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