Individual provider Active NPI

Lan Allen, D.M.D

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1205975299
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6558 Issued in AZ
Practice address
1160 N Pantano Rd
Tucson, AZ 85715-5126
Phone
(520) 886-8503
Fax
(520) 885-6660
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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 D6558 AZ Primary

Addresses

Primary practice location

1160 N Pantano Rd
Tucson, AZ 85715-5126

Mailing address

1160 N Pantano Rd
Tucson, AZ 85715-5126
Phone (520) 886-8503

Other practice location 1

10410 E Rita Ranch Rd
Tucson, AZ 85747-9035
Phone (520) 777-6001

Other practice location 2

1 E Congress St Ste 153
Tucson, AZ 85701-1726
Phone (520) 448-4477

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
D6558AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aeris Dental Downtown LLC General Practice CurrentSince Dec 18, 2022 Accepting new patients
Aeris Family Dental Rita Ranch General Practice Current Accepting new patients
Aeris Family Dental Pantano General Practice Current Accepting new patients

Locations

1160 N Pantano Rd
Tucson, AZ 85715
Phone (520) 886-8503

1 E Congress St
Ste 153
Tucson, AZ 85701
Phone (520) 448-4477

10410 E Rita Ranch Rd
Tucson, AZ 85747
Phone (520) 777-6001

Organizations & group practices 3

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1205975299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 N PANTANO RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857155126",
            "telephone_number": "520-886-8503",
            "fax_number": "520-885-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 N PANTANO RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857155126",
            "telephone_number": "520-886-8503",
            "fax_number": "520-885-6660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10410 E Rita Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857479035",
            "country_code": "US",
            "telephone_number": "520-777-6001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 E Congress St Ste 153",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857011726",
            "country_code": "US",
            "telephone_number": "520-448-4477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "LAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.