Individual provider Active NPI

Rolina Luo, DMD

  • Dentist
National Provider Identifier
1619662095
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13472943-9926 Issued in UT
Practice address
92D Medical Group, 701 Hospital Loop
Suite 350
Apo, AA 99011
Phone
(909) 374-1074
NPI assigned
Apr 10, 2023
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13472943-9926 UT Primary

Addresses

Primary practice location

92D Medical Group, 701 Hospital Loop
Suite 350
Apo, AA 99011

Mailing address

821 N Stanley St Apt B316
Medical Lake, WA 99022-8954
Phone (909) 374-0174

Other practice location 1

203 E Dalke Ave
Spokane, WA 99208-8112
Phone (509) 444-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20250507003102 WA Order and Referring Only - DentistPractitioner - Dentist 9638696271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13472943-9926UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane Dentist Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Dentist Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rolina.luo.1@11411.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1619662095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N STANLEY ST APT B316",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228954",
            "telephone_number": "909-374-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "92D MEDICAL GROUP, 701 HOSPITAL LOOP",
            "address_2": "SUITE 350",
            "city": "APO",
            "state": "AA",
            "postal_code": "99011",
            "telephone_number": "909-374-1074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 E Dalke Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992088112",
            "country_code": "US",
            "telephone_number": "509-444-8200",
            "fax_number": "509-434-0392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUO",
        "first_name": "ROLINA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13472943-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.