Provider Demographics
NPI:1093295149
Name:LUX DENTAL CENTER
Entity Type:Organization
Organization Name:LUX DENTAL CENTER
Other - Org Name:LUX DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-485-2900
Mailing Address - Street 1:43761 PARKHURST PLZ STE 132
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5470
Mailing Address - Country:US
Mailing Address - Phone:571-485-2900
Mailing Address - Fax:
Practice Address - Street 1:43761 PARKHURST PLZ STE 132
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5470
Practice Address - Country:US
Practice Address - Phone:571-485-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty