Provider Demographics
NPI:1811169899
Name:NIETO, LUZ M (DMD)
Entity type:Individual
Prefix:DR
First Name:LUZ
Middle Name:M
Last Name:NIETO
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 1:2082 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1812
Mailing Address - Country:US
Mailing Address - Phone:908-490-0987
Mailing Address - Fax:
Practice Address - Street 1:340 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4730
Practice Address - Country:US
Practice Address - Phone:908-754-2233
Practice Address - Fax:908-754-2158
Is Sole Proprietor?:No
Enumeration Date:2008-03-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01698900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDO6209200OtherCDS LICENSE
NJ22DI01698900OtherBRANCH OFFICE LICENSE
NJDI016989OtherDENTAL LICENSE
NJDI016989OtherDENTAL LICENSE