Kelly W Lucas, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

AA673 Issued in AK

Practice address

2 School House Rd
Naknek, AK 99633

Phone

(907) 357-5214

Fax

(907) 357-5213

NPI assigned

May 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Anchorage Camai Dental Clinic, LLC

  • Dental Clinic/Center
  • Anchorage, AK
  • NPI 1972150365
  NPD Authorized official
• Lake Road Dental LLC

  • Dental Clinic/Center
  • Dillingham, AK
  • NPI 1174016737
  NPD Authorized official
• Naknek Camai Dental Clinic LLC

  • Dental Clinic/Center
  • Naknek, AK
  • NPI 1447743018
  NPD Authorized official
• Camai Dental Clinic LLC

  dba Dental Innovations

  • General Practice Dentistry
  • Wasilla, AK
  • NPI 1376089128
  Authorized official Same address or phone

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023239902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 E PALMER-WASILLA HWY",
            "address_2": "REGAN BLDG SU 5",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547271",
            "telephone_number": "907-357-5214",
            "fax_number": "907-357-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SCHOOL HOUSE RD",
            "city": "NAKNEK",
            "state": "AK",
            "postal_code": "99633",
            "telephone_number": "907-357-5214",
            "fax_number": "907-357-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KELLY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "AA673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0673",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bristol Bay Borough
• Camai Community Health Center, Inc.
• Gayle Darlene Claus, ANP
• Katie Copps, PA-C
• Whitney M Holmes, CPNP
• Rachel Adams Minick, FNP
• Naknek Camai Dental Clinic LLC
• Ann Marie Shankle, CERTIFIED ROLFER

• Dentist in Naknek, AK
• Providers in Naknek, AK by specialty
• Dentist in Alaska

• 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.