Healthcare Provider Details

I. General information

NPI: 1316882467
Provider Name (Legal Business Name): LIBRANDO'S NORTHSTAR DENTAL HYGIENE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 LINCOLN BLVD
MARINA DEL REY CA
90292-6900
US

IV. Provider business mailing address

4750 LINCOLN BLVD APT 214
MARINA DEL REY CA
90292-6987
US

V. Phone/Fax

Practice location:
  • Phone: 907-957-0671
  • Fax:
Mailing address:
  • Phone: 907-957-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: MR. JUFER LIBRANDO
Title or Position: REGISTERED DENTAL HYGIENIST
Credential: RDHAP
Phone: 907-957-0671