Individual provider Active NPI

Lucas T Griffin, DMD

  • Dentist
  • Anniston, AL
National Provider Identifier
1063852952
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6019 Issued in AL
Practice address
1695 Golden Springs Rd
Anniston, AL 36207-7097
Phone
(256) 831-1333
NPI assigned
Jun 25, 2013
Last updated
Jun 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6019 AL Primary

Addresses

Primary practice location

1695 Golden Springs Rd
Anniston, AL 36207-7097

Mailing address

1695 Golden Springs Rd
Anniston, AL 36207-7097
Phone (256) 831-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20161201002060 AL Order and Referring Only - DentistPractitioner - Dentist 9638494867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Travis P. Phillips, DMD, LLC Past Accepting new patients
Al Dental Professionals PC PastSince Jun 23, 2024 Accepting new patients

Organizations & group practices 2

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1063852952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 GOLDEN SPRINGS RD",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362077097",
            "telephone_number": "256-831-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 GOLDEN SPRINGS RD",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362077097",
            "telephone_number": "256-831-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "LUCAS",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

Verify at the official NPI Registry.