Provider Demographics
NPI:1205016029
Name:LUZINAS-SMITH, HARRIET ANN (RDH/AP)
Entity Type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:ANN
Last Name:LUZINAS-SMITH
Suffix:
Gender:F
Credentials:RDH/AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 WELCOME WAY
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-8627
Mailing Address - Country:US
Mailing Address - Phone:760-371-7950
Mailing Address - Fax:
Practice Address - Street 1:1446 WELCOME WAY
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-8627
Practice Address - Country:US
Practice Address - Phone:760-371-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP 50124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist