Individual provider Active NPI

Gregg Lawrence Lurcott, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Denver, CO
National Provider Identifier
1821042896
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
9835 Issued in CO
Practice address
400 S Colorado Blvd
Suite 450
Denver, CO 80246-1253
Phone
(303) 744-1369
Fax
(303) 744-9879
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901017646 MI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 9835 CO Primary

Addresses

Primary practice location

400 S Colorado Blvd
Suite 450
Denver, CO 80246-1253

Mailing address

2 Gooseberry LN
Englewood, CO 80113-4126
Phone (303) 744-1369

Other identifiers 1

IdentifierTypeStateIssuer
970E07680OtherMIBLUE CROSS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000189 CO Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 1759288756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9835COMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma and Emergency Subspecialty Surgeons PLLC Oral and Maxillofacial Surgery CurrentSince Nov 3, 2012 Accepting new patients
Michigan Oms P C Oral and Maxillofacial Surgery PastSince Jan 1, 1995 Accepting new patients
Summit Oral & Maxillofacial Surgery PC Oral and Maxillofacial Surgery PastSince Oct 18, 2017 Accepting new patients

Locations

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

Organizations & group practices 3

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1821042896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GOOSEBERRY LN",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801134126",
            "telephone_number": "303-744-1369",
            "fax_number": "303-744-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S COLORADO BLVD",
            "address_2": "SUITE 450",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461253",
            "telephone_number": "303-744-1369",
            "fax_number": "303-744-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LURCOTT",
        "first_name": "GREGG",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901017646",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "9835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "970E07680",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.