Jonathan Michael Lubeck, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

041411406 Issued in VA

Practice address

5004 Brambleton Ave
Roanoke, VA 24018-4605

Phone

(540) 774-1019

NPI assigned

Sep 28, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 3, 2025 through Nov 3, 2027

Medicare enrollment (NPD)

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.

• Gary a. Roach, DDS, LTD

  • Dentist
  • Roanoke, VA
  • NPI 1093044406
  NPD (past)
• Roanoke Smiles Youth Dentistry, LLC

  • General Practice Dentistry
  • Roanoke, VA
  • NPI 1851489116

  General Practice

  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1811089170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184605",
            "telephone_number": "540-774-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184605",
            "telephone_number": "540-774-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBECK",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "041411406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly F Lower, AU.D.
• Tonita Lowery
• Eva S Lowey, SLP
• Ireen Loyola, CRNA
• Yaohua Lu, MD
• Amanda Belanger Luby, MSN, RN, FNP-C
• Lucas Physical Therapy Inc
• Allison Gillespie Lucas, RPH
• Amy Irene Lucas, MSN, RN, CCNS, CCRNK
• Brenda Kay Lucas, RD

• All providers in Roanoke, VA
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.