# STACY Z. LUKANUSKI DDS PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659560886
- **Authorized official:** DR. STACY LUKANUSKI D.D.S. (DDS)
- **Authorized official phone:** (804) 264-9460

## Contact information

- **Practice address:** 2105 E PARHAM RD, SUITE 107, RICHMOND, VA 23228-2236
- **Practice address phone:** (804) 264-9460
- **Practice address fax:** (804) 264-9462
- **Mailing address:** 2105 E PARHAM RD, SUITE 107, RICHMOND, VA 23228-2236
- **Mailing address phone:** (804) 264-9460
- **Mailing address fax:** (804) 264-9462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401008884 | VA | Yes |

## Other

- **Enumeration date:** 10/24/2007
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 981168 | UNITED CONCORDIA | — |