Active NPI
Lane and Associates Xxxix DDS PA
- Dentist
- Mount Airy, NC
National Provider Identifier
1538776455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- LANE AND ASSOCIATES XXXIX DDS PA
- Practice address
- 161 Kodiak LN
Mount Airy, NC 27030-5399 - Phone
- (336) 789-1025
- Fax
- (336) 789-1158
- NPI assigned
- Sep 24, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alicia Duffy
- Title
- Credentialing Manager
- Phone
- (919) 295-2757
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary | ||
| General Practice Dentistry | 1223G0001X |
Addresses
Primary practice location
161 Kodiak LN
Mount Airy, NC 27030-5399
Mailing address
161 Kodiak LN
Mount Airy, NC 27030-5399
Phone (336) 789-1025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5070979 | Medicaid | NC |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Concord, NC
- NPI 1669008082
-
- General Practice Dentistry
- Fuquay-Varina, NC
- NPI 1659423234
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665014400000",
"number": "1538776455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 KODIAK LN",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270305399",
"telephone_number": "336-789-1025",
"fax_number": "336-789-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 KODIAK LN",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270305399",
"telephone_number": "336-789-1025",
"fax_number": "336-789-1158"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LANE AND ASSOCIATES XXXIX DDS PA",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-24",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A",
"authorized_official_last_name": "DUFFY",
"authorized_official_first_name": "ALICIA",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "919-295-2757"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5070979",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Airy, NC
- Samantha Simpson Kunz, FNP-C
- Laboratory Corporation of America Holdings
- Laboratory Corporation of America Holdings
- Laboratory Corporation of America Holdings
- Malee Lambert, OTR/L
- Emma Lanter, PA-C
- Larry J Moray DDS, Ms, PA
- Angela Lassiter, PHARMD
- Ruth Ann Brown Lattimore, PHARMD
- Laura Y. Mercer, DMD, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.