Mark William Lucas, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901013273 Issued in MI

Practice address

4170 Lennon Rd
Suite C
Flint, MI 48507-1083

Phone

(810) 732-0303

Fax

(810) 732-1360

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912019522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6067 BROOKSTONE LN",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399432",
            "telephone_number": "810-695-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 LENNON RD",
            "address_2": "SUITE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071083",
            "telephone_number": "810-732-0303",
            "fax_number": "810-732-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent D Loy, PT
• Tameka L Loyd, LLMSW
• LT Brothers LLC
• Dunyue Lu, M.D.
• Lisa M. Lucas, APRN-BC, NP
• Nicole Lucas
• Stacey Luck
• Paula Charisse Luckado-Dobbins
• Lucky's Heart Home Care LLC
• Lucky's Pharmacy LLC (Lucky's Pharmacy)

• General Practice Dentistry in Flint, MI
• Providers in Flint, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.