Provider Demographics
NPI:1710319744
Name:SCHAEFER, LULU FANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:LULU
Middle Name:FANG
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LULU
Other - Middle Name:
Other - Last Name:FANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:322 DENTAL SCIENCE BLDG S
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1001
Mailing Address - Country:US
Mailing Address - Phone:319-335-7440
Mailing Address - Fax:319-335-7451
Practice Address - Street 1:341 DENTAL SCIENCE BLDG S
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1001
Practice Address - Country:US
Practice Address - Phone:319-335-7469
Practice Address - Fax:319-335-7451
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292111223G0001X
IARES-30544390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1223G0001XDental ProvidersDentistGeneral Practice