Individual provider Active NPI

Dwayne A Lanz, D.M.D.

  • General Practice Dentistry
  • Reading, PA
National Provider Identifier
1568522654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS027262-L Issued in PA
Practice address
2128 Perkiomen Ave
Reading, PA 19606-1865
Phone
(610) 779-5123
Fax
(610) 779-9408
NPI assigned
Dec 11, 2006
Sex
Male
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
General Practice Dentistry 1223G0001X DS027262-L PA Primary

Addresses

Primary practice location

2128 Perkiomen Ave
Reading, PA 19606-1865

Mailing address

2128 Perkiomen Ave
Reading, PA 19606-1865
Phone (610) 779-5123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150618000497 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618288564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS027262-LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Dental Studio LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568522654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 PERKIOMEN AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196061865",
            "telephone_number": "610-779-5123",
            "fax_number": "610-779-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 PERKIOMEN AVE",
            "city": "READING",
            "state": "PA",
            "postal_code": "196061865",
            "telephone_number": "610-779-5123",
            "fax_number": "610-779-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZ",
        "first_name": "DWAYNE",
        "middle_name": "A",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027262-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.