Individual provider Active NPI

Molly O'Brien Luke, DDS

  • Dentist
  • Moon Township, PA
National Provider Identifier
1770571507
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS039436 Issued in PA
Practice address
960 Beaver Grade Rd
Moon Township, PA 15108-2718
Phone
(660) 864-3399
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3556 WV
Dentist 122300000X 4224 SC
Dentist 122300000X DS039436 PA Primary

Addresses

Primary practice location

960 Beaver Grade Rd
Moon Township, PA 15108-2718

Mailing address

960 Beaver Grade Rd
Moon Township, PA 15108-2718
Phone (660) 864-3399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150618001913 PA Order and Referring Only - DentistPractitioner - Dentist 8527379411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS039436PAMDDentist
3556WVMDPsychiatry Physician
4224SCMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1770571507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 BEAVER GRADE RD",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151082718",
            "telephone_number": "660-864-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BEAVER GRADE RD",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151082718",
            "telephone_number": "660-864-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "MOLLY",
        "middle_name": "O'BRIEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3556",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4224",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moon Township, PA

Sources for this page

Verify at the official NPI Registry.