MEDICARE: LOURDES B. CAPULONG DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	40551	CA

General Provider Information

NPI Number	:	1629450598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOURDES B. CAPULONG DDS INC

Provider Business Mailing Address
First Line	:	4409 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3212
Country	:	US
Telephone Number	:	323-257-7582
Fax Number	:	323-257-2612

Provider Business Practice Location Address
First Line	:	4409 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3212
Country	:	US
Telephone Number	:	323-257-7582
Fax Number	:	323-257-2612

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. LOURDES BUENO CAPULONG
Credential	:	DDS
Telephone Number	:	323-257-7582

Provider Enumeration Date	:	06/26/2015
Last Update Date	:	06/26/2015

Similar Medicare Providers

1275517518 — DR. LOURDES BUENO CAPULONG D.D.S.
Practice Location Address:

4409 EAGLE ROCK BLVD
LOS ANGELES, CA
90041-3212

Practice Phone: 323-257-7582
Practice Fax: 323-257-2612

1659448496 — LIVING WAY INC
Practice Location Address:

4419 EAGLE ROCK BLVD
LOS ANGELES, CA
90041-3212

Practice Phone: 323-550-8236
Practice Fax: 323-550-1768

1396997383 — DR. ELISHA GOLDSTEIN PH.D.
Practice Location Address:

10825 ASHBY AVE
LOS ANGELES, CA
90064-3212

Practice Phone: 310-597-9276
Practice Fax:

1740695139 — HOLLYWOOD LIFESTYLE DERMAOTOGY
Practice Location Address:

7135 HOLLYWOOD BLVD , #306
LOS ANGELES, CA
90046-3212

Practice Phone: 323-301-3378
Practice Fax: 213-256-0685

1972097483 — SANDRA MICHELLE HENRIQUEZ RDHAP
Practice Location Address:

3163 IVY ST
LOS ANGELES, CA
90034-3212

Practice Phone: 310-694-7421
Practice Fax: 310-839-7367

1912479494 — ERIKA LAUREN OBER LMFT
Practice Location Address:

10825 ASHBY AVE
LOS ANGELES, CA
90064-3212

Practice Phone: 213-538-2790
Practice Fax:

Directions to “LOURDES B. CAPULONG DDS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.