Individual provider Active NPI

Lawrence Paul Lotzof, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Diego, CA
National Provider Identifier
1104027267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
42355 Issued in CA
Practice address
3772 Clairemont Dr
San Diego, CA 92117-5916
Phone
(858) 272-4094
Fax
(858) 272-5952
NPI assigned
May 29, 2007
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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 42355 CA Primary

Addresses

Primary practice location

3772 Clairemont Dr
San Diego, CA 92117-5916

Mailing address

3772 Clairemont Dr
San Diego, CA 92117-5916
Phone (858) 272-4094

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
42355CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104027267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 CLAIREMONT DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175916",
            "telephone_number": "858-272-4094",
            "fax_number": "858-272-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 CLAIREMONT DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175916",
            "telephone_number": "858-272-4094",
            "fax_number": "858-272-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTZOF",
        "first_name": "LAWRENCE",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "42355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.