Robert Lucas

Individual provider Active NPI General Practice Dentistry · Delphi, IN

NPI 1497875470 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497875470
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12008506A (IN)
Practice address
204 W Main St
Delphi, IN 46923-1432
Phone
(765) 564-3740
NPI assigned
Mar 31, 2007
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12008506AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Delphi Family Dentistry, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12008506A IN Yes

Addresses

Primary practice location

204 W Main St
Delphi, IN 46923-1432

Mailing address

204 W Main St
Delphi, IN 46923-1432

Other providers in Delphi, IN

All providers in Delphi, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.