Provider Demographics
NPI:1891846119
Name:LUJAN, OLGA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:R
Last Name:LUJAN
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 1:3735 SW 8TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3161
Mailing Address - Country:US
Mailing Address - Phone:305-448-3698
Mailing Address - Fax:
Practice Address - Street 1:3735 SW 8TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3161
Practice Address - Country:US
Practice Address - Phone:305-448-3698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice