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Search › California › 122300000X

Lydia Koernianingsih, DDS

NPI 1083817423 · on the registry since 2007

Practice

Address
1125 E 17th St Ste W234
Santa Ana, CA 92701
Phone
(714) 558-4895
Fax
(714) 558-4896
Organisation at this address
4-110 Inc.
Advanced Care
Mike Quynh Bui
Bid Stone, Llc
Mike Quynh Bui
Inferred from a shared address, not stated in the registry.
Clinicians at this address
45

Registry record

Primary taxonomy
122300000X
122300000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-01-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California