Provider Demographics
NPI:1225825789
Name:LUX DENTAL AND SPA
Entity type:Organization
Organization Name:LUX DENTAL AND SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KVASHENKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-724-4227
Mailing Address - Street 1:3603 PALM HARBOR BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1415
Mailing Address - Country:US
Mailing Address - Phone:727-724-4227
Mailing Address - Fax:
Practice Address - Street 1:3603 PALM HARBOR BLVD STE A
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1415
Practice Address - Country:US
Practice Address - Phone:727-724-4227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental