MEDICARE: DR. VIBHUTI LUTHER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12490	TN

General Provider Information

NPI Number	:	1023858388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIBHUTI LUTHER DDS

Provider Business Mailing Address
First Line	:	9775 US HIGHWAY 64 STE 101
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-8587
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9775 US HIGHWAY 64 STE 101
Second Line	:
City	:	ARLINGTON
State	:	TN
Zip	:	38002-8587
Country	:	US
Telephone Number	:	901-235-0709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

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