Robert M Lucero, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

279701 Issued in UT

Practice address

668 E 12225 S
Suite 101
Draper, UT 84020-8340

Phone

(801) 553-9824

Fax

(801) 553-0471

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Draper Dental PC

  • General Practice Dentistry
  • Draper, UT
  • NPI 1922018050
  NPD (past) Authorized official

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1891912820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 E 12225 S",
            "address_2": "SUITE 101",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208340",
            "telephone_number": "801-553-9824",
            "fax_number": "801-553-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 E 12225 S",
            "address_2": "SUITE 101",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208340",
            "telephone_number": "801-553-9824",
            "fax_number": "801-553-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "2279701",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "279701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alyssa Lowman
• Abrie Luke
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• Morgan Lund, DPT
• Janessa Marie Everett Lundquist, BCBA
• Dalton Lunn

• Dentist in Draper, UT
• Providers in Draper, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.