Provider Demographics
NPI:1811489487
Name:LUSK, ANDREW CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHRISTOPHER
Last Name:LUSK
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 1:305 SCHOFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7331
Mailing Address - Country:US
Mailing Address - Phone:804-601-3139
Mailing Address - Fax:804-451-5993
Practice Address - Street 1:305 SCHOFIELD DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7331
Practice Address - Country:US
Practice Address - Phone:804-601-3139
Practice Address - Fax:804-451-5993
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014169061223P0221X
VA04420003251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry