Individual provider Active NPI

David Ray Luck, DDS

  • General Practice Dentistry
  • Cypress, TX
National Provider Identifier
1841379211
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
TX12745 Issued in TX
Practice address
17990 Huffmeister Rd
Cypress, TX 77429-3427
Phone
(281) 304-1777
Fax
(281) 256-2299
NPI assigned
Nov 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12745 TX
General Practice Dentistry 1223G0001X TX12745 TX Primary

Addresses

Primary practice location

17990 Huffmeister Rd
Cypress, TX 77429-3427

Mailing address

17990 Huffmeister Rd
Cypress, TX 77429-3427
Phone (281) 304-1777

Other identifiers 2

IdentifierTypeStateIssuer
88D469OtherBLUE CROSS
971197OtherUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150928000101 TX Order and Referring Only - DentistPractitioner - Dentist 1850609769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TX12745TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1841379211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17990 HUFFMEISTER RD",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774293427",
            "telephone_number": "281-304-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17990 HUFFMEISTER RD",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774293427",
            "telephone_number": "281-304-1777",
            "fax_number": "281-256-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCK",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "12745",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "TX12745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "88D469",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "971197",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.