DRAPER DENTAL PC (NPI# 1922018050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922018050 |
| Entity Type | Organization |
| Organization Name | DRAPER DENTAL PC |
| Other Organization Name | ROBERT M LUCERO |
| Practice Address |
668 E 12225 S Suite 101 Draper UT 84020-8340 |
| Practice Telephone | 8015539824 |
| Practice Fax Number | 8015530471 |
| Mailing Telephone | 8015539824 |
| Mailing Fax Number | 8015530471 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2017-04-20 |
| Authorized Official Name | DR. ROBERT M LUCERO (OWNER PRESIDENT) |
| Authorized Official Telephone | 8015539824 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
279701-9922 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED CONCORDIA | 783866 | 01 |
| Other Name | Type Code |
|---|---|
| Robert M Lucero | Other Name - Individual/Organization |
| Street Address |
668 E 12225 S SUITE 101 |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-8340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528509353 | Renae Elizabeth Claar | Social Worker | 668 E 12225 S, Ste 202, Draper, UT 84020-8340 | 2017-03-13 |
| 1740620616 | Dana Kroes | Social Worker | 668 E 12225 S, Ste. 202, Draper, UT 84020-8340 | 2013-06-25 |
| 1598971475 | Spencer C Woodbury | Dentist | 668 E 12225 S, Ste 101, Draper, UT 84020-8340 | 2007-05-15 |
| 1891912820 | Robert M Lucero | Dentist | 668 E 12225 S, Suite 101, Draper, UT 84020-8340 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548821044 | Joey Dutson | Dentist | 286 E 12200 S, Draper, UT 84020-7817 | 2019-06-25 |
| 1629557012 | Andrew Jacob Gross | Dentist | 1442 E Draper Pkwy Ste G, Draper, UT 84020-9391 | 2018-08-07 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| 1992257372 | Falling Creek Dental LLC | Dentist | 112 E 12450 S Ste 101, Draper, UT 84020-8057 | 2016-11-01 |
| 1558658112 | Jeffrey Trent Welch | Dentist | 722 Bridle Pointe Cv, Draper, UT 84020-7001 | 2011-07-05 |
| 1316199078 | David Vergil Fischer | Dentist | 11576 S State St Ste 1203, Draper, UT 84020-7118 | 2008-10-14 |
| 1316158314 | Christopher S. Johnson, D.d.s., P.C. | Dentist | 12288 S 900 E, Draper, UT 84020 | 2007-05-24 |
| 1437272986 | Jason Richard Lewis | Dentist | 11447 S 700 E, Draper, UT 84020-9731 | 2007-04-09 |
| 1629191135 | Clark Alan Dana | Dentist | 949 Pioneer Rd, Suite A2, Draper, UT 84020-8200 | 2007-04-09 |
| 1811057284 | Lloyd K. Liu Dmd, PC | Dentist | 432 East 12300 South, Suite 8, Draper, UT 84020 | 2006-12-08 |
| Find all providers in DRAPER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.