Active NPI
Gary A Lozenich, DDS
- Dentist
- Royal Oak, MI
National Provider Identifier
1265651129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 015660
- Practice address
- 4045 W 13 Mile Rd Ste B5
Royal Oak, MI 48073-6640 - Phone
- (248) 280-4500
- Fax
- (248) 280-4502
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 015660 | MI | Primary |
Addresses
Primary practice location
4045 W 13 Mile Rd Ste B5
Royal Oak, MI 48073-6640
Mailing address
4045 W 13 Mile Rd Ste B5
Royal Oak, MI 48073-6640
Phone (248) 280-4500
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 |
|---|---|---|---|
| 015660 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265651129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4045 W 13 MILE RD STE B5",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736640",
"telephone_number": "248-280-4500",
"fax_number": "248-280-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4045 W 13 MILE RD STE B5",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736640",
"telephone_number": "248-280-4500",
"fax_number": "248-280-4502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOZENICH",
"first_name": "GARY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "015660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
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.