JASON HAROLD LUSTIG DDS MD NPI 1750347498

NPI Information

Jason Harold Lustig, DDS MD is an oral and maxillofacial surgery dentist in Shreveport, LA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Jason Harold Lustig, DDS MD NPI is 1750347498. 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:

7600 FERN AVE
BUILDING 1400
SHREVEPORT, LA
ZIP 71105-659
Phone: (318) 797-5812
Fax: (318) 797-0390

The NPI 1750347498 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), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 7/24/2007.

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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