Individual provider Active NPI

Lori A Fitzgerald, DDS

  • Dentist
  • Canfield, OH
National Provider Identifier
1265505663
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20977 Issued in OH
Practice address
5711 Shields Rd
Suite a
Canfield, OH 44406
Phone
(330) 533-0804
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1859681 MA
Dentist 122300000X 20977 OH Primary

Addresses

Primary practice location

5711 Shields Rd
Suite a
Canfield, OH 44406

Mailing address

5711 Shields Rd
Suite a
Canfield, OH 44406
Phone (330) 533-0804

Other practice location 1

11 Bay State Ct
Brewster, MA 02631-2120
Phone (508) 255-0111

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1859681MAMDDentist
20977OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. Past Accepting new patients
Ohio Dental Professionals, Delisle, P.C. PastSince Aug 23, 2020 Accepting new patients
Massachusetts Dental Professionals, P.C. Dentist Past Accepting new patients

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1265505663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 SHIELDS RD",
            "address_2": "SUITE A",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "44406",
            "telephone_number": "330-533-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5711 SHIELDS RD",
            "address_2": "SUITE A",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "44406",
            "telephone_number": "330-533-0804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Bay State Ct",
            "address_purpose": "LOCATION",
            "city": "Brewster",
            "state": "MA",
            "postal_code": "026312120",
            "country_code": "US",
            "telephone_number": "508-255-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859681",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "20977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.