Denver W Lackorn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10475 Issued in TX

Practice address

404 E Mountain St
Seguin, TX 78155-5524

Phone

(830) 379-8900

Fax

(830) 379-8903

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124241633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E MOUNTAIN ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555524",
            "telephone_number": "830-379-8900",
            "fax_number": "830-379-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E MOUNTAIN ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781555524",
            "telephone_number": "830-379-8900",
            "fax_number": "830-379-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKORN",
        "first_name": "DENVER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "10475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Gayle Koenig, PNP-AC
• Tara Kohlenberg
• Andrea Rose Kovach, PT
• Aileen Kronewetter, COTA
• Yu Jie Jack Kuo, M.D.
• Amanda Rene Lacy, FNP
• Richard A Laosa, LPC
• Lara a Perry DDS PA
• Larry M. Speir, DDS, Inc.
• Ariann Lehmann, MS, RD, LD

• General Practice Dentistry in Seguin, TX
• Providers in Seguin, TX by specialty
• General Practice Dentistry in Texas

• 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.