Kathryn Grace Luse, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

24569 Issued in TX

Practice address

4160 Heritage Trace Pkwy
#408
Fort Worth, TX 76244-5312

Phone

(817) 741-4288

Fax

(817) 741-2088

NPI assigned

Jun 1, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401408000000",
    "number": "1588890834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 DARTMOUTH ST",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750432211",
            "telephone_number": "972-345-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 HERITAGE TRACE PKWY",
            "address_2": "#408",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445312",
            "telephone_number": "817-741-4288",
            "fax_number": "817-741-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSE",
        "first_name": "KATHRYN",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2014-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yen Luong
• Francesca Luppert, FNP-C
• Shirley Ann Lupplace, RPH
• Hannah Lupton, HWC
• Rachel Diane Lusby, MD
• Tyra N Lusk
• Jacob Lustgarten, PA-C
• Lustig and Young Orthodontics
• Jeremy Russell Lustig, D.D.S., M.S., P.A.
• Glaiza Lustre

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; 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.

Verify at the official NPI Registry.