Provider Demographics
NPI:1952556805
Name:LUI, DAVID WAI-WAH (DMD MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAI-WAH
Last Name:LUI
Suffix:
Gender:M
Credentials:DMD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5528
Mailing Address - Country:US
Mailing Address - Phone:215-504-0600
Mailing Address - Fax:215-504-0951
Practice Address - Street 1:606 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5528
Practice Address - Country:US
Practice Address - Phone:215-504-0600
Practice Address - Fax:215-504-0951
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0367961223S0112X
VA04014134761223S0112X
VA0101251380204E00000X
PAMD455041204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery