Provider Demographics
NPI:1932306990
Name:LUI, DOUGLAS W, (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:W,
Last Name:LUI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 CALIFORNIA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1380
Mailing Address - Country:US
Mailing Address - Phone:415-387-2334
Mailing Address - Fax:
Practice Address - Street 1:4216 CALIFORNIA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1380
Practice Address - Country:US
Practice Address - Phone:415-387-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice