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General NPI Number Information
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NPI Number | 1790697910
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Entity Type | Individual
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Provider Name | IVY TING-YI LU
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Gender | Female
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 411 W LEMON AVE
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City | ARCADIA
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State | CA
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Zip | 91007-7945
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Country | US
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Telephone | 626-390-0019
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Fax |
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Provider Business Mailing Address
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Address Line | NO.108, ZIMIAN ROAD
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City | KAOHISUNG
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State | ZUOYING DISTRICT
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Zip | 81348
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Country | TW
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 111253
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License Number State | CA
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