Provider Demographics
NPI:1023144136
Name:LUNA, JEANNETTE (DMD)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:
Last Name:LUNA
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 1:45 CALLE CALISTEMON
Mailing Address - Street 2:ESTANCIAS DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3166
Mailing Address - Country:US
Mailing Address - Phone:787-783-1674
Mailing Address - Fax:
Practice Address - Street 1:J4 AVE BETANCES
Practice Address - Street 2:HNAS. DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5108
Practice Address - Country:US
Practice Address - Phone:787-798-8260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14271223P0221X
MA166661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry