Individual provider Active NPI

Lori Lynn Lovelace, D.D.S.

  • Dentist
  • Nampa, ID
National Provider Identifier
1366565897
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D1941 Issued in ID
Practice address
341 W Iowa Ave
Nampa, ID 83686-2856
Phone
(208) 467-7401
Fax
(208) 467-7438
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D1941 ID Primary

Addresses

Primary practice location

341 W Iowa Ave
Nampa, ID 83686-2856

Mailing address

341 W Iowa Ave
Nampa, ID 83686-2856
Phone (208) 467-7401

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
I20160913002335 ID Order and Referring Only - DentistPractitioner - Dentist 5991091290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D1941IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace and Kido Dental Group 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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366565897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-7401",
            "fax_number": "208-467-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-7401",
            "fax_number": "208-467-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "LORI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D1941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.