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General NPI Number Information
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NPI Number | 1902926702
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Entity Type | Individual
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Provider Name | LILIANE SHEPARD D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3211 BUSINESS PARK DR STE A
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City | VISTA
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State | CA
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Zip | 92081-8259
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Country | US
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Telephone | 760-727-6800
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Fax | 760-727-4225
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Provider Business Mailing Address
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Address Line | 630 NORDAHL RD STE D
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City | SAN MARCOS
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State | CA
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Zip | 92069-3541
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Country | US
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Telephone | 760-480-1750
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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 | 41704
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License Number State | CA
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