Provider Demographics
NPI:1487809224
Name:LU, ALAN C (DDS)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:C
Last Name:LU
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 1:1350 GRANT RD
Mailing Address - Street 2:#15
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3228
Mailing Address - Country:US
Mailing Address - Phone:650-964-7950
Mailing Address - Fax:
Practice Address - Street 1:1350 GRANT RD
Practice Address - Street 2:#15
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3228
Practice Address - Country:US
Practice Address - Phone:650-964-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice