MEDICARE: MICHAEL A. LUCKETT, DMD & ASSOCIATES (WESTERN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	122300000X	Dentist
2	1223E0200X	Endodontics
3	1223P0221X	Pediatric Dentistry
4	1223P0300X	Periodontics
5	1223P0700X	Prosthodontics
6	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
7	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1831169218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A. LUCKETT, DMD & ASSOCIATES (WESTERN

Provider Business Mailing Address
First Line	:	17300 DALLAS PARKWAY #1070
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248
Country	:	US
Telephone Number	:	972-755-0880
Fax Number	:	972-755-0890

Provider Business Practice Location Address
First Line	:	6153 SOUTH WESTERN AVENUE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60636
Country	:	US
Telephone Number	:	773-863-0129
Fax Number	:	216-584-1064

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. MICHAEL LUCKETT
Credential	:	DMD
Telephone Number	:	773-863-0129

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	12/28/2011

Similar Medicare Providers

1841814274 — ZUBAIR ASLAM KHAN PA-C
Practice Location Address:

5843 S WESTERN AVE
CHICAGO, IL
60636-1526

Practice Phone: 773-434-8600
Practice Fax:

1457330870 — FRIEND FAMILY HEALTH CENTER, INC
Practice Location Address:

5843 S. WESTERN AVENUE
CHICAGO, IL
60636

Practice Phone: 773-702-2193
Practice Fax: 773-702-4356

1275503211 — SATYA AHUJA M.D.
Practice Location Address:

6535 S WESTERN AVE
CHICAGO, IL
60636-2410

Practice Phone: 312-654-2700
Practice Fax: 312-654-9930

1093769176 — SHIV PHARMACY INCORPORATION
Practice Location Address:

1608 W 69TH ST
CHICAGO, IL
60636-3316

Practice Phone: 773-778-3420
Practice Fax:

1225085772 — AMERICAN DRUG STORES LLC
Practice Location Address:

6057 S WESTERN AVE
CHICAGO, IL
60636-2019

Practice Phone: 773-925-9749
Practice Fax: 773-925-0196

1265463103 — DR. LARRY R ABDULLAH DDS
Practice Location Address:

7013 S WESTERN AVE
CHICAGO, IL
60636-3121

Practice Phone: 773-476-0600
Practice Fax:

Directions to “MICHAEL A. LUCKETT, DMD & ASSOCIATES (WESTERN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.