Luikham Dental PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

26420 Issued in TX

Legal business name

LUIKHAM DENTAL PLLC

Practice address

2605 W Mile 5 Rd Ste 1
Mission, TX 78574-0968

Phone

(956) 583-1000

Fax

(956) 583-8000

NPI assigned

Mar 16, 2015

Organization subpart

No

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

Authorized official

Name

George T Luikham, DDS

Title

Owner/Dentist

Phone

(956) 583-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1295128155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 W MILE 5 RD STE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785740968",
            "telephone_number": "956-583-1000",
            "fax_number": "956-583-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 W MILE 5 RD STE 1",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785740968",
            "telephone_number": "956-583-1000",
            "fax_number": "956-583-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIKHAM DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "LUIKHAM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "956-583-1000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "26420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294738401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lower South Texas Imaging Center
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• Oral and Maxillofacial Surgery (Dentist) in Mission, TX
• Providers in Mission, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.