Individual provider Active NPI

Luke Allen Foster, DDS

  • General Practice Dentistry
  • St Louis Park, MN
National Provider Identifier
1982733341
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12768 Issued in MN
Practice address
4045 Brookside Ave
St Louis Park, MN 55416-2808
Phone
(952) 924-0709
NPI assigned
Mar 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6018 WI
General Practice Dentistry 1223G0001X D12768 MN Primary

Addresses

Primary practice location

4045 Brookside Ave
St Louis Park, MN 55416-2808

Mailing address

4045 Brookside Ave
St Louis Park, MN 55416-2808
Phone (319) 331-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150219002105 MN Order and Referring Only - Other (Non-Physician) 8527383314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12768MNMDGeneral Practice Dentistry
6018WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Luke a. Foster, DDS, PLLC CurrentSince Jul 5, 2020 Accepting new patients

Locations

4047 Brookside Ave
St Louis Park, MN 55416
Phone (612) 823-6483

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1982733341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 BROOKSIDE AVE",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162808",
            "telephone_number": "319-331-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 BROOKSIDE AVE",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162808",
            "telephone_number": "952-924-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "LUKE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6018",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.