Provider Demographics
NPI:1154847804
Name:LUCIAN D NARITA DDS PC
Entity Type:Organization
Organization Name:LUCIAN D NARITA DDS PC
Other - Org Name:AMAZING SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NARITA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-359-8500
Mailing Address - Street 1:210 CENTRAL EXPY S
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8005
Mailing Address - Country:US
Mailing Address - Phone:972-359-8500
Mailing Address - Fax:
Practice Address - Street 1:210 CENTRAL EXPY S
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8005
Practice Address - Country:US
Practice Address - Phone:972-359-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX25518OtherTSBDE