Healthcare Provider Details

I. General information

NPI: 1063552271
Provider Name (Legal Business Name): JAMES F. LOOS DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5848 SPINNAKER BAY DR
LONG BEACH CA
90803-6818
US

IV. Provider business mailing address

5848 SPINNAKER BAY DR
LONG BEACH CA
90803-6818
US

V. Phone/Fax

Practice location:
  • Phone: 562-494-7322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number16210
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES F LOOS
Title or Position: OWNER
Credential: DDS, MS
Phone: 562-494-7322