Individual provider Active NPI

Bruce A Luria, D.D.S.

  • Dentist
  • Dearborn, MI
National Provider Identifier
1477606374
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
010699 Issued in MI
Practice address
22914 Michigan Ave
Dearborn, MI 48124-2010
Phone
(313) 565-5507
Fax
(313) 565-9085
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 010699 MI Primary

Addresses

Primary practice location

22914 Michigan Ave
Dearborn, MI 48124-2010

Mailing address

22914 Michigan Ave
Dearborn, MI 48124-2010
Phone (313) 256-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010699MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dearborn Family Dentistry PC Dentist PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 1

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1477606374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22914 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242010",
            "telephone_number": "313-256-5550",
            "fax_number": "313-565-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22914 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242010",
            "telephone_number": "313-565-5507",
            "fax_number": "313-565-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LURIA",
        "first_name": "BRUCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "010699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.