Provider Demographics
NPI:1336847581
Name:AZUREAN LLC
Entity Type:Organization
Organization Name:AZUREAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKITAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBRINOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-724-0805
Mailing Address - Street 1:1914 LINCOLN HWY STE B
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3250
Mailing Address - Country:US
Mailing Address - Phone:732-724-0805
Mailing Address - Fax:732-724-0878
Practice Address - Street 1:1914 LINCOLN HWY STE B
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3250
Practice Address - Country:US
Practice Address - Phone:732-724-0805
Practice Address - Fax:732-724-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental