Lucas Patrick, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DEN4196 Issued in ME

Practice address

3531 Washington St
Suite 102
Boston, MA 02130

Phone

(617) 524-7860

Fax

(617) 524-7861

NPI assigned

Jul 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

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.

• Pure Dental PC

  • Dentist
  • Jamaica Plain, MA
  • NPI 1225326416
  NPD

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1316259674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MARBURY TERRACE",
            "address_2": "UNIT 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-959-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 WASHINGTON ST",
            "address_2": "SUITE 102",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-524-7860",
            "fax_number": "617-524-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "LUCAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN4196",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1857178",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NH",
            "license": "04512",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ME",
            "license": "DEN4196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alichia Louise Paton, ACNP
• Jennifer Shannon Patoulidis, PA
• Patricia Paisley
• David A Patrick Jr., MD
• Heather Patrick, FNP
• William Fernando Macdonald Patrick
• Patrick'S Therapeutic Service
• Patriot Urgent Care Professionals PC
• Silvia Patrizi, M.D.
• Eli Patt, MD

• Periodontics in Boston, MA
• Providers in Boston, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.