Provider Demographics
NPI:1477606465
Name:LUNA, OSCAR ALDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:ALDO
Last Name:LUNA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 PINE ST SE
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4861
Mailing Address - Country:US
Mailing Address - Phone:703-938-1415
Mailing Address - Fax:
Practice Address - Street 1:410 PINE ST SE
Practice Address - Street 2:SUITE # 100
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4861
Practice Address - Country:US
Practice Address - Phone:703-938-1415
Practice Address - Fax:703-255-0295
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014109721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry