Luis Loretto Cuellar III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010544A Issued in IN

Practice address

2005 Roosevelt Rd
Suite B
Valparaiso, IN 46383-2746

Phone

(219) 531-9293

Fax

(219) 531-0537

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

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

• Valparaiso Family Dentistry PC

  • General Practice Dentistry
  • Valparaiso, IN
  • NPI 1093874638

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in IN

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053470104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ROOSEVELT RD",
            "address_2": "SUITE B",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832746",
            "telephone_number": "219-531-9293",
            "fax_number": "219-531-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ROOSEVELT RD",
            "address_2": "SUITE B",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832746",
            "telephone_number": "219-531-9293",
            "fax_number": "219-531-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "LUIS",
        "middle_name": "LORETTO",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010544A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20044390",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crown Cranial & Orthotics, LLC
• Julia Marie Crumrine, PHD HSPP
• Carrie M Cruse
• Sandra Dee Cruz
• Luis L Cuellar Jr., DDS
• Melvyne D. Cueto, RPT
• David Cummins, M.D.
• Antoinette Cundiff, OWNER
• Ayva Cunningham
• Kailynn Denise Curtis, LSW

• All providers in Valparaiso, IN
• General Practice Dentistry in Indiana

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.