Provider Demographics
NPI:1861690901
Name:LKRUBENSTEIN PLLC
Entity type:Organization
Organization Name:LKRUBENSTEIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:RUBENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-874-0990
Mailing Address - Street 1:12725 MCMANUS BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4402
Mailing Address - Country:US
Mailing Address - Phone:757-874-0990
Mailing Address - Fax:757-874-7819
Practice Address - Street 1:12725 MCMANUS BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4402
Practice Address - Country:US
Practice Address - Phone:757-874-0990
Practice Address - Fax:757-874-7819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010057481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty