Provider Demographics
NPI:1942486022
Name:NARITA, LUCIAN DANIEL (DDS)
Entity Type:Individual
Prefix:MR
First Name:LUCIAN
Middle Name:DANIEL
Last Name:NARITA
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 1:210 CENTRAL EXPY S STE 85
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8049
Mailing Address - Country:US
Mailing Address - Phone:972-359-8500
Mailing Address - Fax:
Practice Address - Street 1:210 CENTRAL EXPY S STE 58
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8005
Practice Address - Country:US
Practice Address - Phone:972-359-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56763122300000X
TX25518122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist