Provider Demographics
NPI:1871759621
Name:LO, IRIS (DDS)
Entity type:Individual
Prefix:DR
First Name:IRIS
Middle Name:
Last Name:LO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 DELTA ROSE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-5068
Mailing Address - Country:US
Mailing Address - Phone:917-331-2388
Mailing Address - Fax:
Practice Address - Street 1:4036 DELTA ROSE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-5068
Practice Address - Country:US
Practice Address - Phone:917-331-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC112121223D0004X
NY0578351223D0004X
TX298811223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology