John M Lally, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2164 Issued in AR

Practice address

601 N 2ND St
McGehee, AR 71654-2005

Phone

(870) 222-3926

Fax

(870) 222-4002

NPI assigned

Jul 19, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 31, 2016 through Aug 31, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• J.M. Lally, DDS, LTD

  • General Practice Dentistry
  • McGehee, AR
  • NPI 1730353004
  NPD (past) Authorized official
• Southeast Family Dentistry PLLC

  • General Practice Dentistry
  • McGehee, AR
  • NPI 1255885307
  NPD (past) Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194745745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N 2ND ST",
            "city": "MCGEHEE",
            "state": "AR",
            "postal_code": "716542005",
            "telephone_number": "870-222-3926",
            "fax_number": "870-222-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 2ND ST",
            "city": "MCGEHEE",
            "state": "AR",
            "postal_code": "716542005",
            "telephone_number": "870-222-3926",
            "fax_number": "870-222-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLY",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139106631",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58382",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "000834033",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Faye Jones, RN
• Coretta Jordan, CNA
• Carolyn F. Kilgore, LPN
• Deborah A Kilgore
• Roger D Lafleur, MS LPE
• Judy Faye Lattimore, RN
• Candace Lee, DAY TREATMENT TECH.
• Dwana Lee, RN
• Lee K Long, LCSW
• Megan Leann McDonald, PHARM D

• General Practice Dentistry in McGehee, AR
• Providers in McGehee, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.