Provider Demographics
NPI:1457197154
Name:LAZARIN, LILIANA VALERIA (RDH)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:VALERIA
Last Name:LAZARIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 BLUFF SPRINGS RD APT 831
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-6874
Mailing Address - Country:US
Mailing Address - Phone:210-501-8941
Mailing Address - Fax:
Practice Address - Street 1:2101 E 48TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-2253
Practice Address - Country:US
Practice Address - Phone:303-458-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002026976124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist