Individual provider Active NPI

Susanne Elizabeth Lumpp, D.M.D.

  • General Practice Dentistry
  • Tallahassee, FL
National Provider Identifier
1053462333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14887 Issued in FL
Practice address
1867 Professional Park Cir
Tallahassee, FL 32308-4506
Phone
(850) 942-0772
NPI assigned
Jan 15, 2007
Sex
Female
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 DN14887 FL Primary

Addresses

Primary practice location

1867 Professional Park Cir
Tallahassee, FL 32308-4506

Mailing address

1867 Professional Park Cir
Tallahassee, FL 32308-4506
Phone (850) 942-0772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160518002033 FL Order and Referring Only - DentistPractitioner - Dentist 6002105830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053462333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 PROFESSIONAL PARK CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084506",
            "telephone_number": "850-942-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 PROFESSIONAL PARK CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084506",
            "telephone_number": "850-942-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMPP",
        "first_name": "SUSANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.