Individual provider Active NPI

Virginia M Lujan, DDS

  • General Practice Dentistry
  • Skokomish Nation, WA
National Provider Identifier
1003923350
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00007150 Issued in WA
Practice address
100 N Tribal Center Rd
Skokomish Nation, WA 98584-9748
Phone
(360) 426-5755
Fax
(360) 426-5755
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00007150 WA Primary

Addresses

Primary practice location

100 N Tribal Center Rd
Skokomish Nation, WA 98584-9748

Mailing address

1115 N Tacoma Ave
Tacoma, WA 98403-2930
Phone (253) 228-4429

Other identifiers 1

IdentifierTypeStateIssuer
5022769MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE00007150WAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003923350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 N TACOMA AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984032930",
            "telephone_number": "253-228-4429",
            "fax_number": "253-228-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N TRIBAL CENTER RD",
            "city": "SKOKOMISH NATION",
            "state": "WA",
            "postal_code": "985849748",
            "telephone_number": "360-426-5755",
            "fax_number": "360-426-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUJAN",
        "first_name": "VIRGINIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00007150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5022769",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokomish Nation, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.