MEDICARE: MICHAEL P LUKOVSKY 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	045130	NY

General Provider Information

NPI Number	:	1336275684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL P LUKOVSKY DDS

Provider Business Mailing Address
First Line	:	1515 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-2613
Country	:	US
Telephone Number	:	718-856-7766
Fax Number	:	718-856-7766

Provider Business Practice Location Address
First Line	:	1515 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-2613
Country	:	US
Telephone Number	:	718-856-7766
Fax Number	:	718-856-7766

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

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	05/10/2026

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