Individual provider Active NPI

Lori Price Zimmerman, D.M.D.

  • General Practice Dentistry
  • Spartanburg, SC
National Provider Identifier
1346779402
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3664 Issued in SC
Practice address
127 Southport Rd
Spartanburg, SC 29306-3815
Phone
(864) 595-1203
Fax
(864) 587-2879
NPI assigned
Jun 12, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 3664 SC Primary

Addresses

Primary practice location

127 Southport Rd
Spartanburg, SC 29306-3815

Mailing address

127 Southport Rd
Spartanburg, SC 29306-3815
Phone (864) 595-1203

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

LicenseStateTypeSpecialty
3664SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a Zimmerman, DMD, PA CurrentSince Jun 11, 2023 Accepting new patients

Locations

127 Southport Rd
Spartanburg, SC 29306
Phone (864) 595-1203

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346779402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 SOUTHPORT RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063815",
            "telephone_number": "864-595-1203",
            "fax_number": "864-587-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SOUTHPORT RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063815",
            "telephone_number": "864-595-1203",
            "fax_number": "864-587-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "LORI",
        "middle_name": "PRICE",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.