Provider Demographics
NPI:1194830026
Name:LUEDEMANN, AMY LYNN (DDS, MSD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:LUEDEMANN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27110 CINCO RANCH BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2686
Mailing Address - Country:US
Mailing Address - Phone:281-394-7040
Mailing Address - Fax:
Practice Address - Street 1:27110 CINCO RANCH BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2686
Practice Address - Country:US
Practice Address - Phone:281-394-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADR200001571223P0221X
TX240321223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry