Individual provider Active NPI

Luke Noble, DDS

  • Endodontics
  • Gresham, OR
National Provider Identifier
1962899286
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D11613 Issued in OR
Practice address
320 NE 5TH St
Gresham, OR 97030
Phone
(503) 665-0495
NPI assigned
Apr 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001093-15 WI
Student in an Organized Health Care Education/Training Program 390200000X
Endodontics 1223E0200X D11613 OR Primary

Addresses

Primary practice location

320 NE 5TH St
Gresham, OR 97030

Mailing address

320 NE 5TH St
Gresham, OR 97030-7308
Phone (503) 665-0495

Other practice location 1

49 Diane Ln
Appleton, WI 54915-7203
Phone (920) 809-0485

Other practice location 2

RAF Lakenheath 48 MDG/SGHC
Unit 5115
Apo, AE 09461-5115
Phone (314) 226-8889

Other practice location 3

1120 15th St # Gc5110
Augusta, GA 30912-0004
Phone (706) 721-2251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20251022003958 WA Order and Referring Only - DentistPractitioner - Dentist 2769970664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001093-15WIMDDentist
D11613ORMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1962899286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 NE 5TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307308",
            "telephone_number": "503-665-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 NE 5TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-665-0495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Diane Ln",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549157203",
            "country_code": "US",
            "telephone_number": "920-809-0485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "RAF Lakenheath 48 MDG/SGHC",
            "address_2": "Unit 5115",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "094615115",
            "country_code": "US",
            "telephone_number": "314-226-8889",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "1120 15th St # Gc5110",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "LUKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001093-15",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D11613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.