Individual provider Active NPI

Mary Ellen Lukaswitz, D.M.D.

  • General Practice Dentistry
  • Valhalla, NY
National Provider Identifier
1659402097
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
044472 Issued in NY
Practice address
20 Hospital Oval W
Cedarwood Hall
Valhalla, NY 10595-1559
Phone
(914) 493-8138
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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 044472 NY Primary

Addresses

Primary practice location

20 Hospital Oval W
Cedarwood Hall
Valhalla, NY 10595-1559

Mailing address

172 Country Ridge Dr
Rye Brook, NY 10573-1002
Phone (914) 934-2189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160209001078 NY Order and Referring Only - DentistPractitioner - Dentist 4082918271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1659402097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 COUNTRY RIDGE DR",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731002",
            "telephone_number": "914-934-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOSPITAL OVAL W",
            "address_2": "CEDARWOOD HALL",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951559",
            "telephone_number": "914-493-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASWITZ",
        "first_name": "MARY ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.