Individual provider Active NPI

Spencer D Luke, DMD

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1407055452
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6321727 Issued in UT
Practice address
1011 N Catherine St
Salt Lake City, UT 84116-1600
Phone
(801) 596-3000
Fax
(801) 596-8887
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6321727 UT Primary

Addresses

Primary practice location

1011 N Catherine St
Salt Lake City, UT 84116-1600

Mailing address

1011 N Catherine St
Salt Lake City, UT 84116-1600
Phone (801) 596-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20150917002278 UT Order and Referring Only - DentistPractitioner - Dentist 8022325455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6321727UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kde Dental PLLC Past Accepting new patients
Spencer Luke DMD, Inc. General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1407055452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N CATHERINE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841161600",
            "telephone_number": "801-596-3000",
            "fax_number": "801-596-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N CATHERINE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841161600",
            "telephone_number": "801-596-3000",
            "fax_number": "801-596-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "SPENCER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6321727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.