Provider Demographics
NPI:1790303840
Name:LUU, HARRISON (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:
Last Name:LUU
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 1:4250 SIMMONS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0769
Mailing Address - Country:US
Mailing Address - Phone:702-998-2237
Mailing Address - Fax:
Practice Address - Street 1:4250 SIMMONS ST STE 100
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0769
Practice Address - Country:US
Practice Address - Phone:702-998-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV73581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice