Provider Demographics
NPI:1194397984
Name:LUKEN, MAEVE PATRICIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAEVE
Middle Name:PATRICIA
Last Name:LUKEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 LAKE BALDWIN LN UNIT 309
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6929
Mailing Address - Country:US
Mailing Address - Phone:978-505-3243
Mailing Address - Fax:
Practice Address - Street 1:11050 W COLONIAL DR STE 30
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2998
Practice Address - Country:US
Practice Address - Phone:407-284-3571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist