Provider Demographics
NPI:1770013062
Name:LUAN, JOSEPH ALLEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALLEN
Last Name:LUAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 E RAY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1772
Mailing Address - Country:US
Mailing Address - Phone:480-792-6880
Mailing Address - Fax:
Practice Address - Street 1:1070 E RAY RD STE 7
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-792-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD97841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice