Individual provider Active NPI

Lori Tima, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sheridan, WY
National Provider Identifier
1023415239
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1383 Issued in WY
Practice address
642 Val Vista St
Sheridan, WY 82801-3659
Phone
(307) 672-6917
NPI assigned
Dec 3, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 00203285 CO
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1383 WY Primary

Addresses

Primary practice location

642 Val Vista St
Sheridan, WY 82801-3659

Mailing address

642 Val Vista St
Sheridan, WY 82801-3659
Phone (307) 672-6917

Other practice location 1

5100 W 20th St Ste B
Greeley, CO 80634-3051
Phone (970) 372-0277

Other practice location 2

4360 Boardwalk Dr Ste 200
Fort Collins, CO 80525-5940
Phone (970) 226-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1383WYMDProfessional Counselor
00203285COMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023415239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013659",
            "telephone_number": "307-672-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013659",
            "telephone_number": "307-672-6917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 W 20th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806343051",
            "country_code": "US",
            "telephone_number": "970-372-0277",
            "fax_number": "970-226-8669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4360 Boardwalk Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805255940",
            "country_code": "US",
            "telephone_number": "970-226-5505",
            "fax_number": "970-226-8669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMA",
        "first_name": "LORI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "00203285",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WY",
            "license": "1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.