Kevin J Luba, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 18775 Issued in FL

Practice address

1449 NW Saint Lucie West Blvd
Port St Lucie, FL 34986-1968

Phone

(772) 348-4409

Fax

(772) 348-4344

NPI assigned

Nov 10, 2008

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Atlantic Dental Management Company PA

  • Dentist
  • Port St Lucie, FL
  • NPI 1306450556
  NPD
• PSL Dental Management

  • Dentist
  • Port St Lucie, FL
  • NPI 1245082247
  NPD

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1801040399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11965 SW BENNINGTON CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872721",
            "telephone_number": "954-673-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861968",
            "telephone_number": "772-348-4409",
            "fax_number": "772-348-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBA",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-10",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Lowell
• Vanessa Loyd Sotomayor, RD, LD
• Rene Mario Loyola, M.D.
• Yanetsi Lozada Borges
• Lsquared Essentials, LLC
• Angela June Lucas, FNP-C
• Lucille a Vandevere, LLC
• Kelli Lugo, P.A.
• Roberto Lugo, M.D.
• Thomas Lukat, PHARM D

• General Practice Dentistry in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.