Eric Lynn Osborne Jr., DENTAL LAB TECH

Primary specialty

Dental Laboratory TechnicianTaxonomy code 126900000X

License

T62-66-0416 Issued in VA

Practice address

18945 FM 2252
115
Garden Ridge, TX 78266-2562

Phone

(757) 953-8635

Fax

(757) 953-8597

NPI assigned

Apr 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629190897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 LYONS AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235092557",
            "telephone_number": "757-395-0306",
            "fax_number": "757-953-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18945 FM 2252",
            "address_2": "115",
            "city": "GARDEN RIDGE",
            "state": "TX",
            "postal_code": "782662562",
            "telephone_number": "757-953-8635",
            "fax_number": "757-953-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "ERIC",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DENTAL LAB TECH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126900000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory Technician",
            "state": "VA",
            "license": "T62-66-0416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Laboratory Technician in Garden Ridge, TX
• Providers in Garden Ridge, TX by specialty
• Dental Laboratory Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.