MEDICARE: LUCAS ELITE DENTAL STUDIO

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1477403210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCAS ELITE DENTAL STUDIO

Provider Business Mailing Address
First Line	:	2730 COUNTRY CLUB RD STE C
Second Line	:
City	:	LUCAS
State	:	TX
Zip	:	75002-8781
Country	:	US
Telephone Number	:	972-905-0786
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 COUNTRY CLUB RD STE C
Second Line	:
City	:	LUCAS
State	:	TX
Zip	:	75002-8781
Country	:	US
Telephone Number	:	972-905-0786
Fax Number	:

Authorized Official
Title or Position	:	DENTIST AND PRACTICE OWNER
Name	:	UZMA HAJIYANI
Credential	:	DDS
Telephone Number	:	972-905-0786

Provider Enumeration Date	:	01/31/2026
Last Update Date	:	01/31/2026

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