Provider Demographics
NPI:1952950123
Name:LUMIA DENTAL, PLLC
Entity Type:Organization
Organization Name:LUMIA DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEE KYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-287-1275
Mailing Address - Street 1:160 BROADWAY RM 1004
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4213
Mailing Address - Country:US
Mailing Address - Phone:212-287-1275
Mailing Address - Fax:212-287-1274
Practice Address - Street 1:160 BROADWAY RM 1004
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4213
Practice Address - Country:US
Practice Address - Phone:212-287-1275
Practice Address - Fax:212-287-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty