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General NPI Number Information
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NPI Number | 1780481291
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Entity Type | Organization
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Legal Business Name | LUMIERE DENTAL PLLC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 9524B ROUTE 29
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City | FAIRFAX
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State | VA
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Zip | 22031-2303
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Country | US
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Telephone | 773-512-1811
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Fax | 703-828-8778
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Provider Business Mailing Address
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Address Line | 9524B ROUTE 29
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City | FAIRFAX
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State | VA
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Zip | 22031-2303
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Country | US
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Telephone | 773-512-1811
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Fax | 703-828-8778
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZUKAEY ALLABABIDI
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Credential |
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Telephone | 773-512-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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