Individual provider Active NPI

Carlo Luna, DDS

  • General Practice Dentistry
  • Canton, OH
National Provider Identifier
1629166087
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21973 Issued in OH
Practice address
4220 Belden Village St NW
Canton, OH 44718-2536
Phone
(234) 203-7111
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22408 TX
General Practice Dentistry 1223G0001X 21973 OH Primary

Addresses

Primary practice location

4220 Belden Village St NW
Canton, OH 44718-2536

Mailing address

14509 Carlos St
Frisco, TX 75035-5133
Phone (210) 589-0585

Other practice location 1

16535 Huebner Rd Ste 102
San Antonio, TX 78248-1676
Phone (210) 589-0585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230204000425 OH Order and Referring Only - DentistPractitioner - Dentist 7416329255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22408TXMDSocial Worker
21973OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1629166087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14509 CARLOS ST",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750355133",
            "telephone_number": "210-589-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 BELDEN VILLAGE ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182536",
            "telephone_number": "234-203-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16535 Huebner Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782481676",
            "country_code": "US",
            "telephone_number": "210-589-0585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNA",
        "first_name": "CARLO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22408",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.