Active NPI
Carl J. Luchetti, D.M.D.
- Periodontics
- West Chester, PA
National Provider Identifier
1629113204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS-24231-L
- Practice address
- 795 E Marshall St
Suite 306
West Chester, PA 19380-4400 - Phone
- (610) 692-8121
- Fax
- (610) 696-6457
- NPI assigned
- Feb 21, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS-24231-L | PA | Primary |
Addresses
Primary practice location
795 E Marshall St
Suite 306
West Chester, PA 19380-4400
Mailing address
1307 Pennsford Dr
Downingtown, PA 19335-3679
Phone (610) 692-8121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS-24231-L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629113204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 PENNSFORD DR",
"city": "DOWNINGTOWN",
"state": "PA",
"postal_code": "193353679",
"telephone_number": "610-692-8121",
"fax_number": "610-696-6457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 E MARSHALL ST",
"address_2": "SUITE 306",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193804400",
"telephone_number": "610-692-8121",
"fax_number": "610-696-6457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCHETTI",
"first_name": "CARL",
"middle_name": "J.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS-24231-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.