Individual provider Active NPI

Lucas Benjamin Marrs, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1871755819
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011157A Issued in IN
Practice address
6535 E 82ND St
Suite 211
Indianapolis, IN 46250-4524
Phone
(317) 849-3597
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011157A IN Primary

Addresses

Primary practice location

6535 E 82ND St
Suite 211
Indianapolis, IN 46250-4524

Mailing address

6535 E 82ND St
Suite 211
Indianapolis, IN 46250-4524
Phone (317) 849-3597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200124000983 IN Practitioner - Dentist 5496050973 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011157AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Castleton General & Implant Dentistry PC CurrentSince Dec 18, 2019 Accepting new patients
Mikem.H.Deldar,DDS,PC PastSince Feb 1, 2020 Accepting new patients

Locations

6535 E 82nd St
Ste 211
Indianapolis, IN 46250
Phone (317) 849-3597

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1871755819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 E 82ND ST",
            "address_2": "SUITE 211",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462504524",
            "telephone_number": "317-849-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 E 82ND ST",
            "address_2": "SUITE 211",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462504524",
            "telephone_number": "317-849-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRS",
        "first_name": "LUCAS",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011157A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.