NPIMap

Organization Active NPI

Lisa L. Loftis, D.D.S., P.a.

  • Preferred Provider Organization
  • Malvern, AR
National Provider Identifier
1558452409
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
2905 Issued in AR
Legal business name
LISA L. LOFTIS, D.D.S., P.A.
Practice address
306 S Ash St
Malvern, AR 72104-3918
Phone
(501) 332-4979
Fax
(501) 337-7097
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lisa Lynn Loftis, D.D.S.NPI 1710078803
Title
Owner
Phone
(501) 332-4979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 2905 AR Primary

Addresses

Primary practice location

306 S Ash St
Malvern, AR 72104-3918

Mailing address

306 S Ash St
Malvern, AR 72104-3918
Phone (501) 332-4979

Other identifiers 3

IdentifierTypeStateIssuer
03090017900OtherQUAL CHOICE
58744OtherBLUECROSS BLUESHIELD FED
831360OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

306 S Ash St
Malvern, AR 72104
Phone (501) 332-4979

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558452409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 S ASH ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721043918",
            "telephone_number": "501-332-4979",
            "fax_number": "501-337-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 S ASH ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721043918",
            "telephone_number": "501-332-4979",
            "fax_number": "501-337-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA L. LOFTIS, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOFTIS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-332-4979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "AR",
            "license": "2905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "03090017900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD FED",
            "identifier": "58744",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "831360",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.