Active NPI
Gregory Mark Lutke, DDS
- Dentist
- Plano, TX
National Provider Identifier
1841462785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14658
- Practice address
- 5045 Lorimar Dr
#110
Plano, TX 75093-5720 - Phone
- (972) 378-4141
- Fax
- (775) 871-1573
- NPI assigned
- Apr 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14658 | TX | Primary |
Addresses
Primary practice location
5045 Lorimar Dr
#110
Plano, TX 75093-5720
Mailing address
5045 Lorimar Dr
#110
Plano, TX 75093-5720
Phone (972) 378-4141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14658 | TX | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1841462785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5045 LORIMAR DR",
"address_2": "#110",
"city": "PLANO",
"state": "TX",
"postal_code": "750935720",
"telephone_number": "972-378-4141",
"fax_number": "775-871-1573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5045 LORIMAR DR",
"address_2": "#110",
"city": "PLANO",
"state": "TX",
"postal_code": "750935720",
"telephone_number": "972-378-4141",
"fax_number": "775-871-1573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTKE",
"first_name": "GREGORY",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-01",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "14658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.