Individual provider Active NPI

James A Lucido, D.D.S.

  • General Practice Dentistry
  • Alliance, OH
National Provider Identifier
1407074842
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.017985 Issued in OH
Practice address
721 S Union Ave
Alliance, OH 44601-2932
Phone
(330) 821-0441
Fax
(330) 821-2549
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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 30.017985 OH Primary

Addresses

Primary practice location

721 S Union Ave
Alliance, OH 44601-2932

Mailing address

721 S Union Ave
Alliance, OH 44601-2932
Phone (330) 821-0441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160205001206 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8729382171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1407074842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 S UNION AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446012932",
            "telephone_number": "330-821-0441",
            "fax_number": "330-821-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 S UNION AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446012932",
            "telephone_number": "330-821-0441",
            "fax_number": "330-821-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIDO",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.017985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.