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General NPI Number Information
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NPI Number | 1700122850
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Entity Type | Organization
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Legal Business Name | EVELYN LUMA DDS PLLC
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 1244 PERIMETER PKWY SUITE 444
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-5699
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Country | US
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Telephone | 757-430-2600
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Fax | 757-721-5577
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Provider Business Mailing Address
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Address Line | 1244 PERIMETER PKWY SUITE 444
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-5699
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Country | US
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Telephone | 757-430-2600
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Fax | 757-721-5577
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Authorized Official
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Title or Position | DENTIST
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Name | DR. EVELYN E LUMA
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Credential | DDS
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Telephone | 757-430-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401410284
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License Number State | VA
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