Provider Demographics
NPI:1235298746
Name:LOZNE, ELENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:LOZNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:DINCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2465 HIDDEN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4867
Mailing Address - Country:US
Mailing Address - Phone:651-714-9552
Mailing Address - Fax:
Practice Address - Street 1:8980 HUDSON BLVD N
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-9704
Practice Address - Country:US
Practice Address - Phone:651-735-9057
Practice Address - Fax:651-501-1471
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND102251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN61022400Medicaid