Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jeremy Russell Lustig, DDS, MS, PA

Individual provider Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1760562235

Dr. Jeremy Russell Lustig, DDS, MS, PA is an Orthodontics and Dentofacial Orthopedics Dentistry in Fort Worth, Texas. Works from 5 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.
MS — Master of Science
A graduate science degree.
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

8450 Park Vista Blvd
Fort Worth, TX 76137-5731
Phone: (817) 514-1717
Fax: (817) 704-4771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 1025 Boyd Rd, Azle, TX 76020-2517 — (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
  • 705 W Bailey Boswell Rd Ste 100, Saginaw, TX 76179-1020 — (817) 514-1717

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 20612 (TX)

Record details

NPI number1760562235
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , MS , PA
Sole proprietorNo
NPI enumeratedOctober 17, 2006
Last updated in NPPESFebruary 28, 2024
Certification dateFebruary 28, 2024

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