Travis Duane Lutz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30.020826 Issued in OH

Practice address

800 E Wayne St
Celina, OH 45822-1359

Phone

(419) 586-1615

NPI assigned

Mar 23, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

Practice roles

Locations

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.

• 3390 West Elm Family Dentistry LLC

  • General Practice Dentistry
  • Lima, OH
  • NPI 1457143059
  NPD Authorized official
• Grand Lake Family Dentistry, LTD.

  • Dentist
  • Celina, OH
  • NPI 1952428310
  NPD Authorized official

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1295852655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 316",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458220316",
            "telephone_number": "419-586-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E WAYNE ST",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458221359",
            "telephone_number": "419-586-1615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 W Spring St",
            "address_purpose": "LOCATION",
            "city": "Saint Marys",
            "state": "OH",
            "postal_code": "458852312",
            "country_code": "US",
            "telephone_number": "419-394-5178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "TRAVIS",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.020826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9182631",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "06131",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2057965",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Lee Lovitt, RPH
• Jessica Lynn Lozier, APRN-CNP
• Heidi Luebke
• Mallory Lutz, DDS
• Nathaniel Lutz, DDS
• Majestic Care of Celina LLC
• Marden B Lacuesta MD Inc
• Kiersten Renee Martin, FNP-C
• Kristina M Martin
• Melinda Martin

• Dentist in Celina, OH
• Providers in Celina, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.