Jeffrey Michael Luchetti

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

12613 Issued in NC

Practice address

8305 Falls of Neuse Rd Ste 105
Raleigh, NC 27615-3546

Phone

(717) 576-0372

NPI assigned

Mar 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

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 and National Provider Directory roles.

• K. Kevin Neshat, DDS, MD, PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Raleigh, NC
  • NPI 1770637779
  NPD (past)

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1114555448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 FALLS OF NEUSE RD STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153546",
            "telephone_number": "717-576-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8305 FALLS OF NEUSE RD STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153546",
            "telephone_number": "717-576-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCHETTI",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "12613",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "018.002141",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.032918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macie Lucas, PA-C
• Miha S Lucas, MD
• Rachael Hadley Lucas, PA-C
• Xyon Lucas
• Jessica Lucero, SLP-CF
• Timothy Luchetti, MD
• Carla Lucia, M. ED. LPC
• Deana Marie Luciano, LCMHC, LCAS
• Janet Niquette Lucien, D.O.
• Camieko Chantese Luck, FNP-BC

• Oral & Maxillofacial Surgery (D.M.D.) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.