Provider Demographics
NPI:1811568249
Name:LUSTIG, LAUREN LOUISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:LOUISE
Last Name:LUSTIG
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 1:1684 MONROE ST APT 9
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1854
Mailing Address - Country:US
Mailing Address - Phone:720-243-2812
Mailing Address - Fax:
Practice Address - Street 1:8089 S LINCOLN ST STE 102
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2719
Practice Address - Country:US
Practice Address - Phone:303-794-9271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204825122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist