KENNETH JARED LUSK D.D.S. NPI 1437164233

NPI Information

Kenneth Jared Lusk, D.D.S. is a general practice dentist in Farmington, NM. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Kenneth Jared Lusk, D.D.S. NPI is 1437164233. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

204 N AUBURN AVE
FARMINGTON, NM
ZIP 87401-412
Phone: (505) 325-8401
Fax: (505) 325-8705

The NPI 1437164233 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/30/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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