Charles Joseaph Lucero, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4688 Issued in AZ

Practice address

1751 N Stockton Hill Rd
Ste# a
Kingman, AZ 86401-6601

Phone

(928) 718-8668

Fax

(928) 718-2106

NPI assigned

Aug 2, 2005

Reactivated

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kids Little Smiles Dentistry

  • General Practice Dentistry
  • Kingman, AZ
  • NPI 1225274087
  NPD (past) Authorized official

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710988787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 N STOCKTON HILL RD",
            "address_2": "STE# A",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016601",
            "telephone_number": "928-718-8668",
            "fax_number": "928-718-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 N STOCKTON HILL RD",
            "address_2": "STE# A",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016601",
            "telephone_number": "928-718-8668",
            "fax_number": "928-718-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "CHARLES",
        "middle_name": "JOSEAPH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D4688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA PHYSICIANS IPA,",
            "identifier": "356601",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessie Lopez, PH.D.
• Joshua Ryan Lopez, DPT
• Low Cost Medical Suppiies and Service
• Mary Lowell, M.S. C.C.C. SLP
• Jason W Lowry, D.D.S.
• Maria Salisbury Luna-Wolfe, APRN-PMH
• Jeffrey J Lunn, MD
• Daniel Jay Luttrull, PHARMD
• Wendy Luu
• Hellen Ly

• General Practice Dentistry in Kingman, AZ
• Providers in Kingman, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.