| Sheldon Xiaochen Lu Dmd Inc | |
|
17501 Irvine Blvd Suite 101 Tustin CA 92780-3103 | |
| (714) 835-4441 | |
| (714) 835-0188 |
| Full Name | Sheldon Xiaochen Lu Dmd Inc |
|---|---|
| Speciality | Dentist |
| Location | 17501 Irvine Blvd, Tustin, California |
| Authorized Official Name and Position | Sheldon Xiaochen Lu (OWNER) |
| Authorized Official Contact | 7148354441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheldon Xiaochen Lu Dmd Inc 17501 Irvine Blvd Ste 101 Tustin CA 92780-3147 Ph: (714) 835-4441 | Sheldon Xiaochen Lu Dmd Inc 17501 Irvine Blvd Suite 101 Tustin CA 92780-3103 Ph: (714) 835-4441 |
| NPI Number | 1417479890 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1456619147 |
|---|---|
| Medicare Enrollment ID | O20180102000894 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417479890 | NPI | - | NPPES |
| 528732 | Medicaid | CA |
| Provider Name | Sheldon Xiaochen Lu |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1306039169 PECOS PAC ID: 8820392467 Enrollment ID: I20160202002078 |
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