Individual provider Active NPI

Michael Luzuriaga, D.D.S.

  • General Practice Dentistry
  • Westminster, MD
National Provider Identifier
1013085216
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
06799 Issued in MD
Practice address
20 S Center St
Westminster, MD 21157-5204
Phone
(410) 848-5656
Fax
(410) 848-6646
NPI assigned
Dec 4, 2006
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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 06799 MD Primary

Addresses

Primary practice location

20 S Center St
Westminster, MD 21157-5204

Mailing address

20 S Center St
Westminster, MD 21157-5204
Phone (410) 848-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112000055 MD Order and Referring Only - DentistPractitioner - Dentist 4688984206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06799MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
LK Dental LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1013085216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S CENTER ST",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575204",
            "telephone_number": "410-848-5656",
            "fax_number": "410-848-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S CENTER ST",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575204",
            "telephone_number": "410-848-5656",
            "fax_number": "410-848-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUZURIAGA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "06799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.