DR. JACOB COLBERT LUEDER D.D.S., M.S.
NPI 1952591109
Dentist - Periodontics in Coopersville, MI

Q: What is Jacob Lueder's NPI number?

The NPI number for Jacob Lueder is 1952591109. It was assigned to this individual provider in the NPPES registry on July 25, 2007.

Q: What is Jacob Lueder's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: Is Jacob Lueder enrolled in Medicare?

No. Jacob Lueder has opted out of Medicare through November 4, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jacob Lueder was last updated on January 8, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 25, 2007Opted out of Medicare · through Nov 4, 2027

706 W RANDALL ST, COOPERSVILLE, MI 49404(616) 837-7604(616) 837-6549 Get Directions Write a Review

NPPES record last updated: January 8, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Jacob Colbert Lueder D.d.s., M.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB COLBERT LUEDER D.D.S., M.S. (NPI 1952591109) is an individual periodontics provider in Coopersville, Michigan, licensed in Michigan (2901018860) and active in the NPI registry since July 2007. He has opted out of Medicare through November 4, 2027.

NPPES Registry Identity

NPI1952591109

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. JACOB COLBERT LUEDERCredential: D.D.S., M.S.

Location Address706 W RANDALL STCoopersville, MI 49404-1308

Mailing Address600 Monroe Ave Nw, Loft 205Grand Rapids, MI 49503-1473 · (616) 717-0218

Phone(616) 837-7604

Fax(616) 837-6549

Sole ProprietorNo

Enumeration DateJuly 25, 2007

Last NPPES UpdateJanuary 8, 2009

✔ NPI 1952591109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in MI · 2901018860

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

706 W RANDALL ST, Coopersville, MI 49404

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Michigan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jacob Colbert Lueder D.d.s., M.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 4, 2015 through November 4, 2027.

Opt-Out Effective DateNovember 4, 2015

Opt-Out In Effect ThroughNovember 4, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID M SHABLUK DDS, PC

Dentist (General Practice)

706 W RANDALL ST
COOPERSVILLE, MI 49404

Ottawa County (616) 837-6521

DR. DAVID M SHABLUK D.D.S.

Dentist (General Practice)

706 W RANDALL ST
COOPERSVILLE, MI 49404

Ottawa County (616) 837-6521

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Lueder's NPI number?

The NPI number for Jacob Lueder is 1952591109. It was assigned to this individual provider in the NPPES registry on July 25, 2007.

Where is Jacob Lueder located?

Jacob Lueder practices at 706 W Randall St, Coopersville, MI 49404. The listed phone number is (616) 837-7604.

What is Jacob Lueder's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Jacob Lueder enrolled in Medicare?

No. Jacob Lueder has opted out of Medicare through November 4, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Jacob Lueder accept?

Health plans from Delta Dental of Michigan list Jacob Lueder as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Lueder was last updated on January 8, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.