Provider Demographics
NPI:1528207982
Name:LUNA, ADRIANA (LICENSE NO RDA69026)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:LICENSE NO RDA69026
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 N. AZUSA AVE.
Mailing Address - Street 2:SUITE C
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722
Mailing Address - Country:US
Mailing Address - Phone:626-858-9940
Mailing Address - Fax:
Practice Address - Street 1:1406 N. AZUSA AVE.
Practice Address - Street 2:SUITE C
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722
Practice Address - Country:US
Practice Address - Phone:626-858-9940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant