Provider Demographics
NPI:1053729723
Name:JENNIFER Y LUNA DDS PLLC
Entity type:Organization
Organization Name:JENNIFER Y LUNA DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:YONG
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-226-3495
Mailing Address - Street 1:22725 44TH AVE W STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-4583
Mailing Address - Country:US
Mailing Address - Phone:425-412-3955
Mailing Address - Fax:425-967-5583
Practice Address - Street 1:22725 44TH AVE W STE 100
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-4583
Practice Address - Country:US
Practice Address - Phone:425-412-3955
Practice Address - Fax:425-967-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA122300000X122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty