Angelita Y. Luciano D.M.D., INC.

Clinic/Center, Dental in San Jose, CA. Organization (NPI-2).

NPI number1891972063

StatusActive

Last updated in NPPESJan 30, 2008

Details

NPI: 1891972063
Entity type: Organization (NPI-2)
Legal business name: Angelita Y. Luciano D.M.D., INC.
Organization subpart: No
Enumeration date: Jan 30, 2008
Last updated: Jan 30, 2008

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QD0000X	Clinic/Center, Dental	41274	CA	Yes

Other names

None (Doing Business As)

Practice location

1695 Alum Rock Ave
Suite #1
San Jose, CA 95116-2445

Phone 408-258-3584 · Fax 408-258-3586

Mailing address

1695 Alum Rock Ave
Suite #1
San Jose, CA 95116-2445

Phone 408-258-3584 · Fax 408-258-3586

Authorized official

Bernardo Lapena Luciano
Office Manager
4082583584

Is something wrong?

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