Individual provider Active NPI

David A Luker, DDS

  • Dentist
  • Boise, ID
National Provider Identifier
1407260128
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D4585 Issued in ID
Practice address
514 S El Blanco Dr
Boise, ID 83709-0444
Phone
(801) 885-4669
NPI assigned
Jun 20, 2014
Last updated
Jun 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D4585 ID Primary

Addresses

Primary practice location

514 S El Blanco Dr
Boise, ID 83709-0444

Mailing address

514 S El Blanco Dr
Boise, ID 83709-0444
Phone (801) 885-4669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160622000679 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5597056556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4585IDMDDentist
10200NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1407260128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 S EL BLANCO DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090444",
            "telephone_number": "801-885-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S EL BLANCO DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090444",
            "telephone_number": "801-885-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKER",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.