Lucille Dental,LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1040252 Issued in AK

Legal business name

LUCILLE DENTAL,LLC

Practice address

110 E Swanson Ave
Wasilla, AK 99654-7024

Phone

(907) 376-5207

NPI assigned

Aug 3, 2016

Last updated

Aug 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kris P Gurr, D.D.S.

Title

Owner/President

Phone

(480) 353-0027

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1891248118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E SWANSON AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547024",
            "telephone_number": "907-376-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E SWANSON AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547024",
            "telephone_number": "907-376-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCILLE DENTAL,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "GURR",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "480-353-0027",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1040252",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby A Lucas, D.C.
• Gina Lucas, OTR/L
• Brandy Lucero
• Diana Lucero
• Kaylee Lucia I
• Donna Marie Lufkin, LPN
• Bradley D Lundell
• Cheryl L Lundy, LCSW
• Jonathan F Lundy, PSYD
• Molly Lee Lunsford, CNM, WHNP-BC, RN

• General Practice Dentistry in Wasilla, AK
• Providers in Wasilla, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.