Individual provider Active NPI

Christopher George Lugo, D.M.D.

  • Pediatric Dentistry
  • Marysville, WA
National Provider Identifier
1750492989
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
000009918 Issued in WA
Practice address
919 State Ave Ste 104
Marysville, WA 98270-4284
Phone
(360) 659-8100
Fax
(360) 659-8133
NPI assigned
Aug 31, 2006
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 38909 TX
Pediatric Dentistry 1223P0221X 000009918 WA Primary

Addresses

Primary practice location

919 State Ave Ste 104
Marysville, WA 98270-4284

Mailing address

919 State Ave Ste 104
Marysville, WA 98270-4284
Phone (206) 992-4420

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000009918WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
PSPD - Lake Stevens PLLC Pediatric Dentistry Past Accepting new patients
PSPD - Stanwood, PLLC Pediatric Dentistry Past Accepting new patients
PSPD - Marysville, PLLC Pediatric Dentistry Past Accepting new patients
Puget Sound Dental Professionals PLLC PastSince Jun 15, 2021 Accepting new patients
PSPD - Everett, PLLC Pediatric Dentistry PastSince Jun 27, 2021 Accepting new patients
PSPD - Monroe, PLLC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1750492989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 STATE AVE STE 104",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704284",
            "telephone_number": "206-992-4420",
            "fax_number": "360-659-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 STATE AVE STE 104",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704284",
            "telephone_number": "360-659-8100",
            "fax_number": "360-659-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "CHRISTOPHER",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "38909",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "000009918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.