Provider Demographics
NPI:1205938842
Name:LUZIETTI, FREDRICK WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDRICK
Middle Name:WILLIAM
Last Name:LUZIETTI
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 1:2021 K ST NW
Mailing Address - Street 2:SUITE 518
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1003
Mailing Address - Country:US
Mailing Address - Phone:202-296-4356
Mailing Address - Fax:202-293-2274
Practice Address - Street 1:2021 K ST NW
Practice Address - Street 2:SUITE 518
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1003
Practice Address - Country:US
Practice Address - Phone:202-296-4356
Practice Address - Fax:202-293-2274
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC36301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice