Healthcare Provider Details

I. General information

NPI: 1679914204
Provider Name (Legal Business Name): CYNTHIA SCHEINES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 11/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11092 ANDERSON ST
LOMA LINDA CA
92350-3001
US

IV. Provider business mailing address

7245 SW ALOMA WAY
PORTLAND OR
97223-7926
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4643
  • Fax: 909-558-7959
Mailing address:
  • Phone: 503-206-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDDS100734
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: