Organization Active NPI

Lumina Dental of Lutz, PA

Doing business as Lumina Dental of Lutz

  • Dental Clinic/Center
  • Lutz, FL
National Provider Identifier
1952949141
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LUMINA DENTAL OF LUTZ, PA
Doing business as
Lumina Dental of Lutz
Practice address
2425 Brunello Trce
Lutz, FL 33558-7800
Phone
(813) 381-5858
NPI assigned
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Dr. John D Ivey, DMD
Title
Owner
Phone
(813) 381-5858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

2425 Brunello Trce
Lutz, FL 33558-7800

Mailing address

2945 Guinevere Dr
Titusville, FL 32780-5916
Phone (321) 431-2208

Other names 1

  • LUMINA DENTAL OF LUTZ Doing business as

National Provider Directory

National Provider Directory

Locations

2425 Brunello Trce
Lutz, FL 33558
Phone (813) 381-5858

Practitioners & affiliated clinicians

Practitioners 1

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": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1952949141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 GUINEVERE DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805916",
            "telephone_number": "321-431-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BRUNELLO TRCE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335587800",
            "telephone_number": "813-381-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINA DENTAL OF LUTZ, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-381-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LUMINA DENTAL OF LUTZ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.