Healthcare Provider Details

I. General information

NPI: 1326976374
Provider Name (Legal Business Name): NATHANIEL LUTZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E WAYNE ST
CELINA OH
45822-1359
US

IV. Provider business mailing address

800 E WAYNE ST
CELINA OH
45822-1359
US

V. Phone/Fax

Practice location:
  • Phone: 419-586-1615
  • Fax:
Mailing address:
  • Phone: 419-586-1615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.028425
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: