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General NPI Number Information
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NPI Number | 1346458718
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Entity Type | Individual
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Provider Name | LUIS FERNANDO LEMOS DDS
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 1825 UNIVERSITY AVE SUITE A
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City | RIVERSIDE
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State | CA
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Zip | 92507-5345
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Country | US
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Telephone | 951-781-7884
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Fax |
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Provider Business Mailing Address
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Address Line | 10875 SINCLARE CIR
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City | LOMA LINDA
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State | CA
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Zip | 92354-6549
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Country | US
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Telephone | 909-435-9616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 54278
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License Number State | CA
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