Active NPI
Paul Frank Luther Jr., D.D.S.
- General Practice Dentistry
- Fairview, TN
National Provider Identifier
1528057098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3733
- Practice address
- 2140 Fairview Blvd
Fairview, TN 37062-9065 - Phone
- (615) 799-9964
- Fax
- (615) 799-9981
- NPI assigned
- Oct 18, 2005
- Last updated
- Jun 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3733 | TN | Primary |
Addresses
Primary practice location
2140 Fairview Blvd
Fairview, TN 37062-9065
Mailing address
2140 Fairview Blvd
Fairview, TN 37062-9065
Phone (615) 799-9964
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160812001555 | TN | Order and Referring Only - Dentist | 1355635376 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3733 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466553600000",
"number": "1528057098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2140 FAIRVIEW BLVD",
"city": "FAIRVIEW",
"state": "TN",
"postal_code": "370629065",
"telephone_number": "615-799-9964",
"fax_number": "615-799-9981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 FAIRVIEW BLVD",
"city": "FAIRVIEW",
"state": "TN",
"postal_code": "370629065",
"telephone_number": "615-799-9964",
"fax_number": "615-799-9981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTHER",
"first_name": "PAUL",
"middle_name": "FRANK",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2016-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "3733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairview, TN
- Caleb Timothy King, DMD
- KJK LLC (Goodlark Pharmacy at Fairview)
- Nicholas Kramer
- Devin Kye Krekel, D.M.D
- Allison Leich Hilbun
- Lesley Marie Mathis, ACNP
- Jennifer McMahan, LMSW
- Mercy Health Service - Fairview High School (Mercy Community Healthcare)
- Mercy Health Services - Fairview Elementary School (Mercy Community Healthcare)
- Mercy Health Services - Fairview Middle School (Mercy Community Healthcare)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.