Active NPI
Eileen M Lujan, DMD
- Endodontics
- Miami, FL
National Provider Identifier
1093935587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN14049
- Practice address
- 45 Ponce de Leon Blvd
Miami, FL 33135-1040 - Phone
- (305) 448-4433
- Fax
- (305) 441-2821
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN14049 | FL | Primary |
Addresses
Primary practice location
45 Ponce de Leon Blvd
Miami, FL 33135-1040
Mailing address
45 Ponce de Leon Blvd
Miami, FL 33135-1040
Phone (305) 448-4433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DN14049 | Other | FL | DENTAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 12, 2015 through Aug 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN14049 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1093935587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 PONCE DE LEON BLVD",
"city": "MIAMI",
"state": "FL",
"postal_code": "331351040",
"telephone_number": "305-448-4433",
"fax_number": "305-441-2821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 PONCE DE LEON BLVD",
"city": "MIAMI",
"state": "FL",
"postal_code": "331351040",
"telephone_number": "305-448-4433",
"fax_number": "305-441-2821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUJAN",
"first_name": "EILEEN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN14049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "DN14049",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.