Individual provider Active NPI

Jeffrey T Lodl, D.D.S.

  • General Practice Dentistry
  • Arvada, CO
National Provider Identifier
1053341818
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106280 Issued in CO
Practice address
5730 Ward Rd
Suite 204
Arvada, CO 80002-1300
Phone
(303) 424-0767
Fax
(303) 424-7324
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 106280 CO Primary

Addresses

Primary practice location

5730 Ward Rd
Suite 204
Arvada, CO 80002-1300

Mailing address

5730 Ward Rd
Suite 204
Arvada, CO 80002-1300
Phone (303) 424-0767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201124002409 CO Practitioner - Dentist 9931510872 Practice locations: Arvada, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106280COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey T. Lodl, D.D.S General Practice PastSince Oct 13, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053341818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 WARD RD",
            "address_2": "SUITE 204",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021300",
            "telephone_number": "303-424-0767",
            "fax_number": "303-424-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 WARD RD",
            "address_2": "SUITE 204",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021300",
            "telephone_number": "303-424-0767",
            "fax_number": "303-424-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODL",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "106280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.