Daniel Joseph Lotz, DMD

Individual provider Active NPI Dentist · Dulce, NM

NPI 1356797716 · NPPES record last updated Nov 15, 2023

Key facts

NPI
1356797716
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DEN.00203551 (CO)
Practice address
500 N Mundo Dr
Dulce, NM 87528-5176
Phone
(575) 759-3291
Fax
(575) 759-3532
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200925000379 NM Order and Referring Only - Dentist
Practitioner - Dentist
1557780590

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Jicarilla IHS Pharmacy Current
since Nov 19, 2023
Accepting new patients
Dulce Health Center Current
since Nov 19, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00203551 CO Yes

Addresses

Primary practice location

500 N Mundo Dr
Dulce, NM 87528-5176

Mailing address

PO Box 187
Dulce, NM 87528-0187
Phone (575) 759-3291

Other providers in Dulce, NM

All providers in Dulce, NM · Dentist in New Mexico

Sources for this page

Verify at the official NPI Registry.