Individual provider Active NPI

Nathan Robert Lukes, DDS

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1619080504
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
964 Issued in AK
Practice address
3340 Arctic Blvd
#104
Anchorage, AK 99503-4523
Phone
(907) 561-5154
Fax
(907) 561-2253
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 964 AK Primary

Addresses

Primary practice location

3340 Arctic Blvd
#104
Anchorage, AK 99503-4523

Mailing address

PO Box 1693
Girdwood, AK 99587-1693
Phone (907) 783-0214

Other identifiers 1

IdentifierTypeStateIssuer
DD09641MedicaidAK

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151223000118 TX Order and Referring Only - DentistPractitioner - Dentist 3072814789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
964AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nlukes@direct.scf.cc

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1619080504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1693",
            "city": "GIRDWOOD",
            "state": "AK",
            "postal_code": "995871693",
            "telephone_number": "907-783-0214",
            "fax_number": "907-562-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 ARCTIC BLVD",
            "address_2": "#104",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034523",
            "telephone_number": "907-561-5154",
            "fax_number": "907-561-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKES",
        "first_name": "NATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD09641",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.