Healthcare Provider Details

I. General information

NPI: 1245942929
Provider Name (Legal Business Name): LAMBERTON DENTAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3449 VALLE VERDE DR
NAPA CA
94558-2414
US

IV. Provider business mailing address

3270 BEARD RD
NAPA CA
94558-3406
US

V. Phone/Fax

Practice location:
  • Phone: 707-887-5072
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JORDAN ALEXANDER LAMBERTON
Title or Position: ORTHODONTIST
Credential: DDS
Phone: 707-815-8974