Healthcare Provider Details

I. General information

NPI: 1427490176
Provider Name (Legal Business Name): LILIAN CIFARELLI D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34080 GOLDEN LANTERN ST SUITE 201
DANA POINT CA
92629-2679
US

IV. Provider business mailing address

34080 GOLDEN LANTERN ST SUITE 201
DANA POINT CA
92629-2679
US

V. Phone/Fax

Practice location:
  • Phone: 949-661-5664
  • Fax: 949-661-7206
Mailing address:
  • Phone: 949-661-5664
  • Fax: 949-661-7206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number41259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: