NPIMap

Organization Active NPI

Lolo Dental Clinic PC

  • General Practice Dentistry
  • Lolo, MT
National Provider Identifier
1629133186
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOLO DENTAL CLINIC PC
Practice address
108 Tyler Way
Lolo, MT 59847
Phone
(406) 273-0490
Fax
(406) 273-7969
NPI assigned
Dec 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Marie Rose Hillberry
Title
Vice President Lolodental Clinic PC
Phone
(406) 273-0490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X MT Primary

Addresses

Primary practice location

108 Tyler Way
Lolo, MT 59847

Mailing address

PO Box 725
Lolo, MT 59847
Phone (406) 273-0490

National Provider Directory

National Provider Directory

Locations

108 Tyler Way
Lolo, MT 59847
Phone (406) 273-0490

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629133186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "59847",
            "telephone_number": "406-273-0490",
            "fax_number": "406-273-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 TYLER WAY",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "59847",
            "telephone_number": "406-273-0490",
            "fax_number": "406-273-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOLO DENTAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILLBERRY",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "VICE PRESIDENT LOLODENTAL CLINIC PC",
        "authorized_official_telephone_number": "406-273-0490"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lolo, MT

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.