Healthcare Provider Details

I. General information

NPI: 1154999399
Provider Name (Legal Business Name): MEGAN NICOLE LUKE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 W DARTMOUTH ST
OLATHE KS
66061-6690
US

IV. Provider business mailing address

14445 W 121ST TER
OLATHE KS
66062-6058
US

V. Phone/Fax

Practice location:
  • Phone: 913-732-9408
  • Fax:
Mailing address:
  • Phone: 660-541-1521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2021020620
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2021020620
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number61914
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: