Marko Wsewolod Lutzky, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

037691-1 Issued in NY

Practice address

30 East 40TH Street
Suite 706
New York, NY 10016

Phone

(212) 697-8178

NPI assigned

Feb 21, 2012

Last updated

Feb 21, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

State licenses

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1255604203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39-26 65TH STREET",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773638",
            "telephone_number": "212-697-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 EAST 40TH STREET",
            "address_2": "SUITE 706",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-697-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZKY",
        "first_name": "MARKO",
        "middle_name": "WSEWOLOD",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "037691-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Elizabeth Lutz, PA-C
• Samantha Litzinger Lutz, PH.D.
• Sara Jane Lutz, LMSW
• Amanda Beth Lutzker, M.S.ED.
• Harriet C Lutzky, PHD
• Lillian Luu-Valdez
• Amanda Luu, DO
• Cindie Luu
• Elvin Luu
• Heather Luu, LMSW

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.