Luis L Cuellar Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008232A Issued in IN

Practice address

225 Aberdeen Drive
Suite E
Valparaiso, IN 46385

Phone

(219) 548-2322

Fax

(312) 577-0841

NPI assigned

Apr 23, 2008

Last updated

Apr 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Cosmopolitan Dentistry

  • Dental Clinic/Center
  • Valparaiso, IN
  • NPI 1750450052
  NPD (past) Authorized official

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1053586883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 ABERDEEN DRIVE",
            "address_2": "SUITE E",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46385",
            "telephone_number": "219-548-2322",
            "fax_number": "312-577-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ABERDEEN DRIVE",
            "address_2": "SUITE E",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46385",
            "telephone_number": "219-548-2322",
            "fax_number": "312-577-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "LUIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008232A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crossroads Medical Corporation
• Crown Cranial & Orthotics, LLC
• Julia Marie Crumrine, PHD HSPP
• Carrie M Cruse
• Sandra Dee Cruz
• Luis Loretto Cuellar III, D.D.S.
• Melvyne D. Cueto, RPT
• David Cummins, M.D.
• Antoinette Cundiff, OWNER
• Ayva Cunningham

• General Practice Dentistry in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.