Provider Demographics
NPI:1982830717
Name:LUBIN, JUDITH (DMD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:LUBIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20533 OLD CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2454
Mailing Address - Country:US
Mailing Address - Phone:305-233-1118
Mailing Address - Fax:
Practice Address - Street 1:20533 OLD CUTLER RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-2454
Practice Address - Country:US
Practice Address - Phone:305-233-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN186761223P0300X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6509-63082OtherPRIVATE INSURANCE