Provider Demographics
NPI:1538378179
Name:LUZAR, JEFFERY ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ROBERT
Last Name:LUZAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 N JANSS ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2528
Mailing Address - Country:US
Mailing Address - Phone:949-228-6363
Mailing Address - Fax:
Practice Address - Street 1:363 S MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3833
Practice Address - Country:US
Practice Address - Phone:714-744-8801
Practice Address - Fax:714-744-8629
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist