Provider Demographics
NPI:1447695051
Name:LU, JANE S (DMD MS)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:S
Last Name:LU
Suffix:
Gender:F
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 HIGHWAY 6
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3849
Mailing Address - Country:US
Mailing Address - Phone:281-616-7846
Mailing Address - Fax:
Practice Address - Street 1:5418 HIGHWAY 6
Practice Address - Street 2:SUITE 215
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3849
Practice Address - Country:US
Practice Address - Phone:281-616-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics