Provider Demographics
NPI:1720169618
Name:KAHAN, LUCIAN L (DDS)
Entity Type:Individual
Prefix:
First Name:LUCIAN
Middle Name:L
Last Name:KAHAN
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 1:177 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4482
Mailing Address - Country:US
Mailing Address - Phone:732-257-6500
Mailing Address - Fax:732-257-6531
Practice Address - Street 1:177 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4482
Practice Address - Country:US
Practice Address - Phone:732-257-6500
Practice Address - Fax:732-257-6531
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ112091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics