IndividualActive
Jason Lustig, DDS MD
NPI 1750347498 · Oral and Maxillofacial Surgery (Dentist) · Shreveport, LA
Provider details
- NPI number
- 1750347498
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS MD
- Sex
- Male
- Sole proprietor
- No
- License
- 5776 (LA)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Dental Providers
Practice location
7600 Fern Ave
Building 1400
Shreveport, LA 71105-5659
Phone: (318) 797-5812
Fax: (318) 797-0390
Approximate (ZIP-level) locationGet directions
Mailing address
7600 Fern Ave
Shreveport, LA 71105-5659
Registry dates
- Enumerated
- 2006-04-21
- Last updated
- 2007-07-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.