Organization Active NPI

Luckhardt, PLLC

  • Dental Clinic/Center
  • Charlotte, NC
National Provider Identifier
1225522949
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
10124 Issued in NC
Legal business name
LUCKHARDT, PLLC
Practice address
10801 Woodland Beaver Road
Suite 101
Charlotte, NC 28215
Phone
(704) 888-0607
NPI assigned
Jun 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Diana L Millard, DMDNPI 1972986321
Title
Dentist
Phone
(336) 314-0873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 10124 NC Primary

Addresses

Primary practice location

10801 Woodland Beaver Road
Suite 101
Charlotte, NC 28215

Mailing address

10801 Woodland Beaver Rd Ste 101
Charlotte, NC 28215-5177
Phone (704) 888-0607

National Provider Directory

National Provider Directory

Locations

10801 Woodland Beaver Rd
Ste 101
Charlotte, NC 28215
Phone (704) 888-0607

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1225522949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 WOODLAND BEAVER RD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282155177",
            "telephone_number": "704-888-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 WOODLAND BEAVER ROAD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-888-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKHARDT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "MILLARD",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "336-314-0873",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "10124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.