MEDICARE: PAULINA MICHEL NAVARRO LUGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1164373510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAULINA MICHEL NAVARRO LUGO

Provider Business Mailing Address
First Line	:	655 COLUMBIA ST UNIT 310
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-6763
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE PASEO ENSENADA 1500
Second Line	:
City	:	TIJUANA
State	:	BAJA CALIFORNIA
Zip	:	22506
Country	:	MX
Telephone Number	:
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. PAULINA MICHEL NAVARRO LUGO
Credential	:	DDS
Telephone Number	:	562-352-0417

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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