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General NPI Number Information
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NPI Number | 1972369379
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Entity Type | Individual
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Provider Name | I-WEN LU
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Gender | Female
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Dates
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Enumeration Date | 02/23/2024
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 366 N MAIN ST STE 200
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City | ALPHARETTA
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State | GA
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Zip | 30009-8381
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Country | US
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Telephone | 770-475-6136
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Fax |
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Provider Business Mailing Address
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Address Line | 60 N 23RD ST APT 1606
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1569
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Country | US
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Telephone | 469-323-1578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN123975
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License Number State | GA
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