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General NPI Number Information
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NPI Number | 1831258904
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Entity Type | Individual
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Provider Name | LINDA D. LOTT D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 28040 DOROTHY DR SUITE #201
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4914
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Country | US
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Telephone | 818-889-2061
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Fax | 818-889-2055
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Provider Business Mailing Address
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Address Line | PO BOX 36488
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City | LOS ANGELES
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State | CA
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Zip | 90036-0488
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Country | US
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Telephone | 323-937-0547
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Fax | 323-221-6747
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 24572
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License Number State | CA
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