Lucca Oral and Facial Surgery, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN20676 Issued in MA

Legal business name

LUCCA ORAL AND FACIAL SURGERY, LLC

Practice address

185 Dartmouth St
Suite 403
Boston, MA 02116-5883

Phone

(617) 300-0345

Fax

(617) 993-6970

NPI assigned

Jul 18, 2016

Organization subpart

No

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

Authorized official

Name

Mario Lucca, D.M.D.

Title

Owner

Phone

(617) 300-0345

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1356794069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 DARTMOUTH ST",
            "address_2": "SUITE 403",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165883",
            "telephone_number": "617-300-0345",
            "fax_number": "617-993-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 DARTMOUTH ST",
            "address_2": "SUITE 403",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165883",
            "telephone_number": "617-300-0345",
            "fax_number": "617-993-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCCA ORAL AND FACIAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "LUCCA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-300-0345",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN20676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Lane Lucas, M.D.
• Jane Davenport Lucas, PT
• Janel Lucas, LICSW,DCSW,PHD
• Joshua Lucas
• Michele Roberta Lucas, LICSW
• Mario S Lucca, D.M.D.
• James W Luccarelli, MD
• Leslie Caroline Lucchina, M.D.
• Caroline Luce, PA-C
• Christie J Lucente, PA

• Oral and Maxillofacial Surgery (Dentist) in Boston, MA
• Providers in Boston, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.