Individual provider Active NPI

Courtney Lombardo Lanzi

  • General Practice Dentistry
  • Stuart, FL
National Provider Identifier
1194358556
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24219 Issued in FL
Practice address
5920 SE Federal Hwy
Stuart, FL 34997-7850
Phone
(772) 888-1995
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 24219 FL Primary

Addresses

Primary practice location

5920 SE Federal Hwy
Stuart, FL 34997-7850

Mailing address

5920 SE Federal Hwy
Stuart, FL 34997-7850
Phone (772) 888-1995

Other identifiers 1

IdentifierTypeStateIssuer
24219OtherLICENSE

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
24219FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
TDC Stuart,LLC CurrentSince May 26, 2024 Accepting new patients

Locations

5920 SE Federal Hwy
Stuart, FL 34997
Phone (772) 888-1995

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": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1194358556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977850",
            "telephone_number": "772-888-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977850",
            "telephone_number": "772-888-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZI",
        "first_name": "COURTNEY",
        "middle_name": "LOMBARDO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "24219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "24219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.