Individual provider Active NPI

Robert Dihl Lucus, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1104932664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12006620A Issued in IN
Practice address
6211 North College Ave
Indianapolis, IN 46220-1977
Phone
(317) 255-3221
Fax
(317) 251-0555
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12006620A IN Primary

Addresses

Primary practice location

6211 North College Ave
Indianapolis, IN 46220-1977

Mailing address

6211 North College Ave
Indianapolis, IN 46220-1977
Phone (317) 255-3221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12006620AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104932664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 NORTH COLLEGE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201977",
            "telephone_number": "317-255-3221",
            "fax_number": "317-251-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 NORTH COLLEGE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201977",
            "telephone_number": "317-255-3221",
            "fax_number": "317-251-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCUS",
        "first_name": "ROBERT",
        "middle_name": "DIHL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12006620A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • 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.