Individual provider · Type 1 NPI

Jeremy Russell Lustig, DDS, M.S., P.A.

Orthodontics and Dentofacial Orthopedics Dentistry · Fort Worth, TX

NPI number 1760562235 Active

Practice location

8450 Park Vista Blvd
Fort Worth, TX 76137-5731

Call (817) 514-1717 Map

Fax (817) 704-4771

Other practice locations

  • 1025 Boyd Rd, Azle, TX 76020-2517 · (817) 514-1717
  • 705 W Bailey Boswell Rd Ste 100, Saginaw, TX 76179-1020 · (817) 514-1717
  • 570 FM 156 S Ste 200, Haslet, TX 76052-3626 · (817) 514-1717
  • 601 S Main St, Keller, TX 76248-7029 · (817) 514-1717

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400X20612 (TX)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

4 other providers at this address

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About NPI 1760562235

Jeremy Russell Lustig, DDS, M.S., P.A.'s National Provider Identifier is 1760562235, issued on Oct 17, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Fort Worth, TX. The record was last updated on Feb 28, 2024.