J. Richard Lawrence

Primary specialty

DentistTaxonomy code 122300000X

License

36108 Issued in NY

Legal business name

J. RICHARD LAWRENCE

Practice address

206 Clay Pitts Rd
East Northport, NY 11731-3423

Phone

(631) 266-5061

Fax

(631) 266-5065

NPI assigned

Sep 22, 2010

Last updated

Sep 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Richard Lawrence, D.D.S.

Title

Dentist Owner

Phone

(631) 266-5061

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1467760678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CLAY PITTS ROAD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313421",
            "telephone_number": "631-266-5061",
            "fax_number": "631-266-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CLAY PITTS RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313423",
            "telephone_number": "631-266-5061",
            "fax_number": "631-266-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. RICHARD LAWRENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "631-266-5061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "36108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01200146",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.