Provider Demographics
NPI:1073058996
Name:RILEY, LUKE JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:JAMES
Last Name:RILEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 FM 156 S STE 200
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-3012
Mailing Address - Country:US
Mailing Address - Phone:817-756-9700
Mailing Address - Fax:
Practice Address - Street 1:295 FM 156 S STE 200
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3012
Practice Address - Country:US
Practice Address - Phone:817-439-8393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-01
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist