NPIMap

Organization Active NPI

Draper Dental PC

  • General Practice Dentistry
  • Draper, UT
National Provider Identifier
1922018050
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
279701-9922 Issued in UT
Legal business name
DRAPER DENTAL PC
Practice address
668 E 12225 S
Suite 101
Draper, UT 84020-8340
Phone
(801) 553-9824
Fax
(801) 553-0471
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Dr. Robert M Lucero, DDSNPI 1891912820
Title
Owner President
Phone
(801) 553-9824

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 DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 279701-9922 UT Primary

Addresses

Primary practice location

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

Mailing address

668 E 12225 S
Suite 101
Draper, UT 84020-8340
Phone (801) 553-9824

Other identifiers 1

IdentifierTypeStateIssuer
783866OtherUNITED CONCORDIA

Other names 1

  • Robert M Lucero Other name

National Provider Directory

National Provider Directory

Locations

668 E 12225 S
Ste 101
Draper, UT 84020
Phone (801) 553-9824

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1922018050",
    "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": {
        "organization_name": "DRAPER DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "LUCERO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "801-553-9824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "279701-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "783866",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert M Lucero",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.