KEVIN C. LUCKY DDS PLLC – NPI #1235258757
Clinic/Center

KEVIN C. LUCKY DDS PLLC is an AHC clinic located in BECKLEY, WV. NPPES has assigned the NPI number 1235258757 to KEVIN C. LUCKY DDS PLLC on March 28, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KEVIN C. LUCKY DDS PLLC below.

NPI Profile for
KEVIN C. LUCKY DDS PLLC

NPI Number
1235258757
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KEVIN C. LUCKY DDS PLLC
Primary location
1110 JOHNSTOWN ROAD
BECKLEY, WV 25801
Phone: (304) 255-0717 Fax: (304) 255-0956
Mailing address
832 BROAD STREET
SUMMERSVILLE, WV 26651
Phone: (304) 872-3919 Fax: (304) 872-4043
Organization Subpart
No
Authorized Official
KEVIN LUCKY
OWNER
Phone: (304) 872-3919
Updated
Identifiers

Identifiers for KEVIN C. LUCKY DDS PLLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERINDV. NPI1104970300
MEDICAIDWV3810007754
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.