Provider Demographics
NPI:1558645168
Name:HUSMANN, LUANN JOYCE (RDH)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:JOYCE
Last Name:HUSMANN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1669
Mailing Address - Country:US
Mailing Address - Phone:720-284-4804
Mailing Address - Fax:
Practice Address - Street 1:1420 OGDEN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1910
Practice Address - Country:US
Practice Address - Phone:303-863-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH-906103124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist