Individual provider Active NPI

Richard M. Lubow, D.M.D., M.S.

  • Periodontics
  • St George, UT
National Provider Identifier
1710965959
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
10141315-9921 Issued in UT
Practice address
929 W Sunset Blvd
Saint George, UT 84770
Phone
(515) 705-8358
NPI assigned
Jan 6, 2006
Last updated
Jun 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 10141315-9921 UT Primary

Addresses

Primary practice location

929 W Sunset Blvd
Saint George, UT 84770

Mailing address

929 W Sunset Blvd
Saint George, UT 84770-4865
Phone (515) 705-8358

Other identifiers 2

IdentifierTypeStateIssuer
10141315-8903OtherUTPAHARMACY
10141315-9921OtherUTDENTISTRY

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
10141315-9921UTMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1710965959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 W SUNSET BLVD",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704865",
            "telephone_number": "515-705-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 W SUNSET BLVD",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "84770",
            "telephone_number": "515-705-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBOW",
        "first_name": "RICHARD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "10141315-9921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAHARMACY",
            "identifier": "10141315-8903",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTISTRY",
            "identifier": "10141315-9921",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.