Edward Seymour Lustbader, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

034354 Issued in NY

Practice address

14156 76TH Rd
Flushing, NY 11367-2809

Phone

(718) 261-4600

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: elustbader45139@direct.medisys.org

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235204629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14156 76TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672809",
            "telephone_number": "718-261-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14156 76TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672809",
            "telephone_number": "718-261-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTBADER",
        "first_name": "EDWARD",
        "middle_name": "SEYMOUR",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "034354",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pei Zhi Luo
• Qilie Luo
• Rebecca Luo
• Xiao Luo
• Yong Luo, M.D., PH.D.
• Lux Pharmacy Inc.
• Luxeye Flushing LLC
• Luxottica of America Inc.
• Kevin Luzardo, LPN
• LV Medical Associate, P.C.

• General Practice Dentistry in Flushing, NY
• Providers in Flushing, NY by specialty
• General Practice Dentistry in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.