Active NPI
Lauren Tang
- Dentist
- Phoenix, AZ
National Provider Identifier
1043982309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D011135
- Practice address
- 16350 N Pat Tillman Blvd
Ste 120
Phoenix, AZ 85387 - Phone
- (623) 738-0370
- NPI assigned
- Oct 4, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D011135 | AZ | Primary |
Addresses
Primary practice location
16350 N Pat Tillman Blvd
Ste 120
Phoenix, AZ 85387
Mailing address
16350 N Pat Tillman Blvd
Ste 120
Surprise, AZ 85387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240824000280 | AZ | Order and Referring Only - Dentist | 4284173097 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D011135 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentists of Asante LLP | Dentist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1043982309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16350 N PAT TILLMAN BLVD",
"address_2": "STE 120",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "85387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16350 N PAT TILLMAN BLVD",
"address_2": "STE 120",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85387",
"telephone_number": "623-738-0370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANG",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-04",
"last_updated": "2024-04-18",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D011135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.