Provider Demographics
NPI:1447846241
Name:OSPINA, LUIS F (DDS)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:OSPINA
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 1:6236 KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-1040
Mailing Address - Country:US
Mailing Address - Phone:954-610-1484
Mailing Address - Fax:
Practice Address - Street 1:1900 PRESSLER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3717
Practice Address - Country:US
Practice Address - Phone:713-718-7351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX368651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice