Active NPI
Rodger Lewis McCuistion, DDS
- General Practice Dentistry
- Lubbock, TX
National Provider Identifier
1225044290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12467
- Practice address
- 7805 Slide Rd
Lubbock, TX 79424-2837 - Phone
- (806) 794-6686
- Fax
- (806) 794-2433
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12467 | TX | Primary |
Addresses
Primary practice location
7805 Slide Rd
Lubbock, TX 79424-2837
Mailing address
7805 Slide Rd
Lubbock, TX 79424-2837
Phone (806) 794-6686
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12467 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lubbock Dental Care Professionals, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225044290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7805 SLIDE RD",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794242837",
"telephone_number": "806-794-6686",
"fax_number": "806-794-2433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7805 SLIDE RD",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794242837",
"telephone_number": "806-794-6686",
"fax_number": "806-794-2433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCUISTION",
"first_name": "RODGER",
"middle_name": "LEWIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "12467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
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.