Provider Demographics
NPI:1760008221
Name:URICHIANU, MIHAI LUCIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIHAI
Middle Name:LUCIAN
Last Name:URICHIANU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4808
Mailing Address - Country:US
Mailing Address - Phone:432-978-6331
Mailing Address - Fax:
Practice Address - Street 1:7970 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3890
Practice Address - Country:US
Practice Address - Phone:210-248-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX369331223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty