Provider Demographics
NPI:1083275077
Name:CATHOLIC CHARITIES ARCHDIOCESE OF WASHINGTON
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES ARCHDIOCESE OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCCIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBRUSCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-939-2400
Mailing Address - Street 1:5859 ALLENTOWN WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-2613
Mailing Address - Country:US
Mailing Address - Phone:301-615-0946
Mailing Address - Fax:
Practice Address - Street 1:5859 ALLENTOWN WAY
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-2613
Practice Address - Country:US
Practice Address - Phone:301-615-0946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-21
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty