Provider Demographics
NPI:1063588010
Name:LUMACHI, RONALD F (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:F
Last Name:LUMACHI
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 1:1360 STUYVESANT AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5340
Mailing Address - Country:US
Mailing Address - Phone:908-687-6177
Mailing Address - Fax:
Practice Address - Street 1:1360 STUYVESANT AVENUE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5340
Practice Address - Country:US
Practice Address - Phone:908-687-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1942-7122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist