Lucas Charles Deeter, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1223G0001X Issued in ND

Practice address

1003 Gateway Ave
Bismarck, ND 58503-0508

Phone

(701) 222-1800

NPI assigned

Apr 9, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306969910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 RAYMOND ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013440",
            "telephone_number": "414-477-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 GATEWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030508",
            "telephone_number": "701-222-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETER",
        "first_name": "LUCAS",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1223G0001X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Decoteau Trauma-Informed Care & Practice, PLLC
• Makalie Decoteau
• Waylon Decoteau, MD
• Michele Ann Dees, PT
• Deeter & Deeter Dentistry Partnership (Deeter Dental)
• Matthew K Deeter, DDS
• Nathan Michael Deeter, DDS
• Terry C Deeter, DDS
• Craig Degree, PHD
• Dei Optical Company

• General Practice Dentistry in Bismarck, ND
• Providers in Bismarck, ND by specialty
• General Practice Dentistry in North Dakota

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.