Judith Ellen Lucas, CDA-RDA

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

49000634 Issued in NY

Practice address

790 Ridge Rd
Lackawanna, NY 14218-1629

Phone

(716) 823-9352

NPI assigned

Mar 19, 2010

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1629392634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 RIDGE RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181629",
            "telephone_number": "716-823-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 RIDGE RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181629",
            "telephone_number": "716-823-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JUDITH",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "CDA-RDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NY",
            "license": "49000634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Assistant in Lackawanna, NY
• Providers in Lackawanna, NY by specialty
• Dental Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.