Josef W Lubisich, D.M.D., M.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00010088 Issued in WA

Practice address

300 SE 120TH Ave
Ste. 100
Vancouver, WA 98683-4090

Phone

(360) 256-1755

Fax

(360) 882-8080

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Lubisich & Lubisich DMD PLLC

  • Dentist
  • Vancouver, WA
  • NPI 1598295156
  NPD (past) Authorized official
• Lubisich & Lubisich, PLLC

  • Pediatric Dentistry
  • Vancouver, WA
  • NPI 1912228073
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326260035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SE 120TH AVE",
            "address_2": "STE. 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834090",
            "telephone_number": "360-256-1755",
            "fax_number": "360-882-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SE 120TH AVE",
            "address_2": "STE. 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834090",
            "telephone_number": "360-256-1755",
            "fax_number": "360-882-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBISICH",
        "first_name": "JOSEF",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00010088",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D8681",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5049481",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Tonghua Lu, M.D.
• Dulce Lua
• Lubisich & Lubisich DMD PLLC
• Lubisich & Lubisich, PLLC
• Erinne Bissonnette Lubisich, D.M.D.
• Peter Lubisich, DDS
• Peter Lubisich IV, D.M.D.
• Clare Lucas, LMHC, MS
• Lindsey Yukiko Lucas, LPN
• Megan Adelle Lucas, BS, GCAC, AAC

• Pediatric Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.