Provider Demographics
NPI:1497068886
Name:LEMKE, LJUBA (DMD)
Entity Type:Individual
Prefix:
First Name:LJUBA
Middle Name:
Last Name:LEMKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 RIVERGATE
Mailing Address - Street 2:B1-106
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7470
Mailing Address - Country:US
Mailing Address - Phone:856-979-7566
Mailing Address - Fax:
Practice Address - Street 1:555 RIVERGATE
Practice Address - Street 2:B1-106
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7470
Practice Address - Country:US
Practice Address - Phone:856-979-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 21000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist