Individual provider Active NPI

Thomas Randal Lane, D.M.D

  • General Practice Dentistry
  • Fort Lauderdale, FL
National Provider Identifier
1598882326
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0011299 Issued in FL
Practice address
1831 NE 45TH St
Suite B
Fort Lauderdale, FL 33308-5117
Phone
(954) 771-3331
Fax
(954) 771-7795
NPI assigned
Mar 25, 2007
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 DN0011299 FL Primary

Addresses

Primary practice location

1831 NE 45TH St
Suite B
Fort Lauderdale, FL 33308-5117

Mailing address

1831 NE 45TH St
Suite B
Fort Lauderdale, FL 33308-5117
Phone (954) 771-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181016000136 FL Order and Referring Only - DentistPractitioner - Dentist 1658664388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0011299FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, P.a. General Practice 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": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598882326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 NE 45TH ST",
            "address_2": "SUITE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085117",
            "telephone_number": "954-771-3331",
            "fax_number": "954-771-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 NE 45TH ST",
            "address_2": "SUITE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085117",
            "telephone_number": "954-771-3331",
            "fax_number": "954-771-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "THOMAS",
        "middle_name": "RANDAL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0011299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.