Provider Demographics
NPI:1881760809
Name:LUU, BRIANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:
Last Name:LUU
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 1:4873 MOUNT ROYAL CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2917
Mailing Address - Country:US
Mailing Address - Phone:562-981-4048
Mailing Address - Fax:562-981-5074
Practice Address - Street 1:17660 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6410
Practice Address - Country:US
Practice Address - Phone:562-461-1180
Practice Address - Fax:562-804-0863
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2020-11-10
Deactivation Date:2020-09-17
Deactivation Code:
Reactivation Date:2020-11-10
Provider Licenses
StateLicense IDTaxonomies
CA485031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice