Jack R Lazer, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS021727L Issued in PA

Practice address

105 McCort PL
Johnstown, PA 15904-1303

Phone

(814) 269-4404

Fax

(814) 266-8668

NPI assigned

Nov 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in PA

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Jack R. Lazer, D.M.D., P.C.

  • General Practice Dentistry
  • Johnstown, PA
  • NPI 1194890418
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255409280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MCCORT PLACE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-269-4404",
            "fax_number": "214-266-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MCCORT PL",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159041303",
            "telephone_number": "814-269-4404",
            "fax_number": "814-266-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZER",
        "first_name": "JACK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS021727L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurel Pediatric Associates Inc
• Laurel Urology Inc
• Martina B Laurito, LCSW
• David Francis Lawless, MD
• Roberta Lawrence
• Tyler Michael Lazer, D.M.D.
• James Charles Leahey, DDS
• Donald M Leckey, OD
• Cynthia Terese Ledney, R.D.,L.D.N
• Michaela Ledonne, DO

• Dentist in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Dentist in Pennsylvania

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.