Provider Demographics
NPI:1548459662
Name:LUAN, VINCENT (DDS)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:LUAN
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 1:1601 MAIN ST STE 307
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3230
Mailing Address - Country:US
Mailing Address - Phone:281-238-4746
Mailing Address - Fax:713-271-9668
Practice Address - Street 1:1601 MAIN ST STE 307
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3230
Practice Address - Country:US
Practice Address - Phone:281-238-4746
Practice Address - Fax:281-763-2627
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55851122300000X
TX213961223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist