DR. STEPHANIE VICTORIA LUSTOFIN (NPI# 1720607328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720607328 |
| Entity Type | Individual |
| Full Name | DR. STEPHANIE VICTORIA LUSTOFIN |
| Credential | DDS |
| Practice Address |
325 9th Ave Seattle WA 98104-2420 |
| Mailing Address |
1959 Ne Pacific St Seattle WA 98195-0001 |
| Practice Telephone | 4132211616 |
| Mailing Telephone | 2065437496 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | DR61068968 | WA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
325 9TH AVE |
| City | SEATTLE |
| State | WA |
| Zip Code | 98104-2420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851395743 | Judith Kay Glann | Nurse Practitioner | 325 9th Ave, Seattle, WA 98104-2420 | 2005-06-08 |
| 1720688427 | Angelo John Jamora | Advanced Practice Midwife | 325 9th Ave, Seattle, WA 98104-2420 | 2020-10-30 |
| 1174123939 | Kaitlin C Fitzgerald | Physician Assistant | 325 9th Ave, Seattle, WA 98104-2420 | 2020-10-29 |
| 1184222739 | Kristi Griffing | Registered Nurse | 325 9th Ave, Seattle, WA 98104-2499 | 2020-10-15 |
| 1558968925 | Maeve Muldowney | Anesthesiology | 325 9th Ave, Seattle, WA 98104-2420 | 2020-10-07 |
| 1073128203 | Allison Engstrom | Social Worker | 325 9th Ave, Seattle, WA 98104-2499 | 2020-09-14 |
| 1376158501 | Vallie Jacobson | Registered Nurse | 325 9th Ave, Seattle, WA 98104-2420 | 2020-09-14 |
| 1801401187 | Leigh Anne Kalaman | Registered Nurse | 325 9th Ave, Seattle, WA 98104-2499 | 2020-09-13 |
| 1114532496 | Shayna Erickson | Pharmacist | 325 9th Ave, Seattle, WA 98104-2420 | 2020-09-13 |
| 1144834698 | Tonya L Webb | Registered Nurse | 325 9th Ave, Seattle, WA 98104-2420 | 2020-09-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394312 | Richard Charles Harruff | Pathology | King County Medical Examiners Office, 325 Ninth Avenue, Seattle, WA 98104 | 2020-04-13 |
| 1558999474 | Nathan Richard Benner | Student in an Organized Health Care Education/Training Program | Uw Medicine-harborview Medical Center Orthopaedics, 325 Ninth Avenue, Seattle, WA 98104 | 2020-03-27 |
| 1063058493 | Brook, LLC. | Health Educator | 311 1/2 Occidental Ave South, Suite 210, Seattle, WA 98104 | 2019-11-20 |
| 1609418813 | Stephanie Amanda Ann Mason | Student in an Organized Health Care Education/Training Program | 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104 | 2019-10-09 |
| 1013480250 | Robert Kenneth Lozier | Pedorthist | Norm Maleng Building, 410 9th Ave, 4th Floor, Seattle, WA 98104 | 2019-01-10 |
| 1548739576 | Lee Hanses | Physical Therapist | 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 | 2018-11-20 |
| 1821579095 | Karissa Lin Lee | Pharmacist | 401 Broadway #2075, Seattle, WA 98104 | 2018-08-27 |
| 1477042091 | Maham Jehangir | Student in an Organized Health Care Education/Training Program | 325 9th Ave Department of Radiology, Seattle, WA 98104 | 2018-05-09 |
| 1740786581 | Philip Daniel Tolley | Student in an Organized Health Care Education/Training Program | 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 | 2018-04-02 |
| 1528564242 | Vanessa Dawn Leonhard | Student in an Organized Health Care Education/Training Program | 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 | 2018-04-02 |
| Find all providers in zip 98104 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112575 | Charles David Smith | Oral & Maxillofacial Surgery | 1959 Ne Pacific Street; Hsb Room B 241, Seattle, WA 98195-0001 | 2020-04-03 |
| 1366079972 | Aaron Hui | Oral & Maxillofacial Surgery | 6222 Ne 74th Street Building 25, 2nd Floor, Seattle, WA 98115 | 2020-03-24 |
| 1275093973 | Elizabeth Grace Knoff Floodeen | Oral & Maxillofacial Surgery | University of Washington Department of Surgery, 1959 Ne Pacific Street, Seattle, WA 98195 | 2019-03-20 |
| 1952840274 | Onyinyechi Kelechukwu Esonu | Oral & Maxillofacial Surgery | 1959 Ne Pacific St # 357134, University of Washington Department of Oral Surgery, Seattle, WA 98195-0001 | 2017-02-20 |
| 1598146730 | Chia-lin Michael Tsai | Oral & Maxillofacial Surgery | 1959 Ne Pacific Street Hsb Rm B241, Box 357134, Seattle, WA 98195-0001 | 2015-06-12 |
| 1386037570 | Rodney Nakano Nishimoto | Oral & Maxillofacial Surgery | University of Washington Oms, 1959 Ne Pacific Street Box 357134, Seattle, WA 98195 | 2015-03-11 |
| 1164815569 | Joseph Garcia | Oral & Maxillofacial Surgery | 2960 Eastlake Ave E Apt 208, Seattle, WA 98102-2003 | 2015-03-09 |
| 1154687770 | Joshua Stephen Brandner | Oral & Maxillofacial Surgery | 1959 Ne Pacific Street Box 357134, Seattle, WA 98195-3372 | 2012-04-09 |
| 1629699715 | Jardin Yousef | Oral & Maxillofacial Surgery | 1959 Ne Pacific Street Hsb # B241, Seattle, WA 98195-0001 | 2020-04-30 |
| 1982223574 | Da Min Park | Oral & Maxillofacial Surgery | 1959 Ne Pacific Street Hsb # B241, Seattle, WA 98195-0001 | 2020-04-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.