Provider Demographics
NPI:1568475481
Name:LUMA, EVELYN EPOSI (DDS)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:EPOSI
Last Name:LUMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 PERIMETER PKWY
Mailing Address - Street 2:SUITE444
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5699
Mailing Address - Country:US
Mailing Address - Phone:757-430-2600
Mailing Address - Fax:757-721-5577
Practice Address - Street 1:1244 PERIMETER PKWY
Practice Address - Street 2:SUITE444
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5699
Practice Address - Country:US
Practice Address - Phone:757-430-2600
Practice Address - Fax:757-721-5577
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014102841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9178657Medicaid
VA176807OtherBCBS ANTHEM
VA1566153OtherUCCI