Active NPI
Andrew Lane, DDS
- Dentist
- Healdsburg, CA
National Provider Identifier
1245398411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49772
- Practice address
- 1381 University St
Healdsburg, CA 95448-3314 - Phone
- (707) 431-8234
- Fax
- (707) 431-1427
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 49772 | CA | Primary |
Addresses
Primary practice location
1381 University St
Healdsburg, CA 95448-3314
Mailing address
1381 University St
Healdsburg, CA 95448-3314
Phone (707) 431-8234
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49772 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Medical Center | Past | Accepting new patients | |
| Alliance Medical Center, Inc. | Past | Accepting new patients |
Interoperability endpoints
- alane26856@direct.ochin.org
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Healdsburg, CA
- NPI 1750399796
-
- Clinic/Center
- Windsor, CA
- NPI 1518418862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245398411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1381 UNIVERSITY ST",
"city": "HEALDSBURG",
"state": "CA",
"postal_code": "954483314",
"telephone_number": "707-431-8234",
"fax_number": "707-431-1427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1381 UNIVERSITY ST",
"city": "HEALDSBURG",
"state": "CA",
"postal_code": "954483314",
"telephone_number": "707-431-8234",
"fax_number": "707-431-1427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "ANDREW",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Healdsburg, CA
Sources for this page
- 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.