Provider Demographics
NPI:1871041525
Name:NIKONOFF, LUBOV EUGENIA (DDS)
Entity Type:Individual
Prefix:
First Name:LUBOV
Middle Name:EUGENIA
Last Name:NIKONOFF
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 1:8221 GULF FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-4539
Mailing Address - Country:US
Mailing Address - Phone:713-645-7700
Mailing Address - Fax:
Practice Address - Street 1:8221 GULF FWY STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-4539
Practice Address - Country:US
Practice Address - Phone:713-645-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist