Dietrich Robert Lawrenz, MD DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11096DDS Issued in MN

Practice address

2519 Commerce Dr NW Ste 110
Rochester, MN 55901-4433

Phone

(507) 281-5000

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

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

Yes, effective Apr 4, 2024 through Apr 4, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Southeastern Minnesota Oral & Maxillofacial Surgery Associates

  • Oral and Maxillofacial Surgery Clinic/Center
  • Rochester, MN
  • NPI 1659492312
  NPD (past) Authorized official
• Oral & Maxillofacial Surgery Specialists, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Blaine, MN
  • NPI 1467563510
  NPD (past)
• Oral & Maxillofacial Surgery Specialists, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Waconia, MN
  • NPI 1770694812
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1215964481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 LYTHRUM LN",
            "city": "MEDINA",
            "state": "MN",
            "postal_code": "55340",
            "telephone_number": "612-788-9246",
            "fax_number": "612-788-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 COMMERCE DR NW STE 110",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559014433",
            "telephone_number": "507-281-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENZ",
        "first_name": "DIETRICH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "11096DDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lawrence
• Kelsey Anne Lawrence, LADC
• Makayla Lawrence, PT
• Thomas Charles Lawrence, PT
• Thomas M Lawrence, MBCHB
• John F Lawson III, DDS MS
• Nicole Susanne Lawson, C.N.P.
• Trisha Domantay Laxamana, M.D.
• Raymond Lay, MD
• Katie Rae Layden, D.C.

• Oral and Maxillofacial Surgery (Dentist) in Rochester, MN
• Providers in Rochester, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.