Individual provider Active NPI

Melinda G Lucas, D.M.D.

  • General Practice Dentistry
  • Hattiesburg, MS
National Provider Identifier
1962413336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2340-87 Issued in MS
Practice address
6657 U S Highway 98
Hattiesburg, MS 39402-8442
Phone
(601) 264-0537
Fax
(601) 268-7395
NPI assigned
Aug 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2340-87 MS Primary

Addresses

Primary practice location

6657 U S Highway 98
Hattiesburg, MS 39402-8442

Mailing address

6657 U S Highway 98
Hattiesburg, MS 39402-8442
Phone (601) 264-0537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20151207000162 MS Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7810297389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Grove Family Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962413336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6657 U S HIGHWAY 98",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028442",
            "telephone_number": "601-264-0537",
            "fax_number": "601-268-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6657 U S HIGHWAY 98",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028442",
            "telephone_number": "601-264-0537",
            "fax_number": "601-268-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "MELINDA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2340-87",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.