Larry D Luethke, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS5001 Issued in TN

Practice address

117 W Sevier Ave
Suite 220
Kingsport, TN 37660-3799

Phone

(423) 224-3200

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• L Alan Bacon DDS PC & John Collins DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Johnson City, TN
  • NPI 1518969229
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1972504371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799",
            "telephone_number": "423-224-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETHKE",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS5001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1518969229",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1609878388",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "3726194",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1972504389",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Sanders Lovett, DMD
• Lovinginhomecareinc
• Anna Elizabeth Lowe
• Kelsey Lynn Lowry, DPT
• Lawrence K. Luber, D.M.D.
• Angela M Lundy, NP
• Luxottica of America Inc.
• Tara Nichole Lyall
• Marvin E Lymberis, M.D.
• Rebecca Jane Lyons

• Oral and Maxillofacial Surgery (Dentist) in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.