Trace Lanier Lynn, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

LA5970 Issued in LA

Practice address

3107 Maplewood Dr
Sulphur, LA 70663-6201

Phone

(337) 625-9911

Fax

(337) 625-9912

NPI assigned

Jun 9, 2009

Last updated

Nov 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 May 9, 2016 through May 9, 2028

Medicare enrollment (NPD)

Not 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.

• Lynn Family Dentistry

  • General Practice Dentistry
  • Sulphur, LA
  • NPI 1851765556
  NPD (past) Authorized official
• E Suzanne McCrory DDS Apc

  • Dentist
  • Sulphur, LA
  • NPI 1346240678
  NPD (past)

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1265668974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 MAPLEWOOD DR",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706636201",
            "telephone_number": "337-625-9911",
            "fax_number": "337-625-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 MAPLEWOOD DR",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706636201",
            "telephone_number": "337-625-9911",
            "fax_number": "337-625-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "TRACE",
        "middle_name": "LANIER",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "LA5970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louisiana Occupational Medicine and Safety Institute (Workforce Medical Center)
• Louisiana United Methodist Children & Family Services, Inc (Methodist Children's Home of Southwest Louisiana)
• Kristina Adele Lounsberry, PT
• Tammy Ly, DDS
• Lynn Family Dentistry
• Karla Lyons
• Manning Dental Associates Inc
• Bryan A Manning, DDS
• Dean L Manning, DDS
• Maplewood Family Medicine Clinic

• Dentist in Sulphur, LA
• Providers in Sulphur, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; 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.