Individual provider Active NPI

David Nicholas Luther, DMD

  • Pediatric Dentistry
  • Trinity, FL
National Provider Identifier
1710535349
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN23779 Issued in FL
Practice address
8804 Hawbuck St
Trinity, FL 34655-5360
Phone
(727) 478-3210
NPI assigned
Aug 27, 2019
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN23779 FL Primary

Addresses

Primary practice location

8804 Hawbuck St
Trinity, FL 34655-5360

Mailing address

8804 Hawbuck St
Trinity, FL 34655-5360

Other practice location 1

3165 N McMullen Booth Rd
Clearwater, FL 33761-2032
Phone (727) 478-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260107000959 CA Practitioner - Pediatric Dentistry 7416443700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Dentistry
Education
Nova Southeastern Univ College of Dental Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

120 Stony Point Rd
Suite 200
Santa Rosa, CA 95401-4132

5481 Wilshire Dr
Santa Rosa, CA 95404-1055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23779FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelican Pediatric Dentistry LLC Pediatric Dentistry Current Accepting new patients
Santa Rosa Community Health Centers CurrentSince Dec 15, 2025 Accepting new patients
Christopher E. Chuong DMD, PLC Pediatric Dentistry PastSince Mar 29, 2020 Accepting new patients

Locations

1300 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 303-3395

3569 Round Barn Cir
Santa Rosa, CA 95403

Organizations & group practices 4

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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1710535349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8804 HAWBUCK ST",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8804 HAWBUCK ST",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555360",
            "telephone_number": "727-478-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3165 N McMullen Booth Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612032",
            "country_code": "US",
            "telephone_number": "727-478-3210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "DAVID",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN23779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.