Provider Demographics
NPI:1235620733
Name:GANG ANTHONY LU, D.M.D., INC
Entity Type:Organization
Organization Name:GANG ANTHONY LU, D.M.D., INC
Other - Org Name:DOWNTOWN DENTAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GANG
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:216-616-1155
Mailing Address - Street 1:1110 EUCLID AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-1626
Mailing Address - Country:US
Mailing Address - Phone:216-616-1155
Mailing Address - Fax:
Practice Address - Street 1:1110 EUCLID AVE STE 202
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115
Practice Address - Country:US
Practice Address - Phone:216-616-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025103261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental