Individual provider Active NPI

Rodger Lewis McCuistion, DDS

  • General Practice Dentistry
  • Lubbock, TX
National Provider Identifier
1225044290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12467 Issued in TX
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

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
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

LicenseStateTypeSpecialty
12467TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock Dental Care Professionals, PLLC PastSince Jul 24, 2022 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.

Verify at the official NPI Registry.