Individual provider Active NPI

Lorin E Dixon, DMD

  • General Practice Dentistry
  • Idaho Falls, ID
National Provider Identifier
1275640443
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D1975 Issued in ID
Practice address
205 Elm St Ste a
Idaho Falls, ID 83402-4054
Phone
(208) 524-2771
Fax
(208) 519-4277
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D1975 ID Primary

Addresses

Primary practice location

205 Elm St Ste a
Idaho Falls, ID 83402-4054

Mailing address

205 Elm St Ste a
Idaho Falls, ID 83402-4054
Phone (208) 524-2771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20160108000909 ID Order and Referring Only - DentistPractitioner - Dentist 2769784602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D1975IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dixon Dental Center Past Accepting new patients

Organizations & group practices 1

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1275640443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ELM ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024054",
            "telephone_number": "208-524-2771",
            "fax_number": "208-519-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ELM ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024054",
            "telephone_number": "208-524-2771",
            "fax_number": "208-519-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "LORIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.