NPIMap

Organization Active NPI

Kendalyn Lutz-Craver DDS PA

  • General Practice Dentistry
  • Shelby, NC
National Provider Identifier
1881797066
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7628 Issued in NC
Legal business name
KENDALYN LUTZ-CRAVER DDS PA
Practice address
101 Life Enrichment Blvd.
Shelby, NC 28150
Phone
(704) 482-5119
Fax
(704) 669-2710
NPI assigned
Sep 6, 2006
Last updated
Oct 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Authorized official

Name
Dr. Kendalyn Paige Lutz-Craver, DDSNPI 1982875209
Title
President
Phone
(704) 482-5119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7628 NC Primary

Addresses

Primary practice location

101 Life Enrichment Blvd.
Shelby, NC 28150

Mailing address

101 Life Enrichment Blvd.
Shelby, NC 28150
Phone (704) 482-5119

Other identifiers 2

IdentifierTypeStateIssuer
902Y2OtherNCBCBS
89902Y2MedicaidNC

National Provider Directory

National Provider Directory

Locations

101 Life Enrichment Blvd
Shelby, NC 28150
Phone (704) 482-5119

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1881797066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LIFE ENRICHMENT BLVD.",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28150",
            "telephone_number": "704-482-5119",
            "fax_number": "704-669-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LIFE ENRICHMENT BLVD.",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28150",
            "telephone_number": "704-482-5119",
            "fax_number": "704-669-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALYN LUTZ-CRAVER DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "LUTZ-CRAVER",
        "authorized_official_first_name": "KENDALYN",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-482-5119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "902Y2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902Y2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.