Individual provider Active NPI

Tommie Harold Lancaster, DDS

  • General Practice Dentistry
  • Kinston, NC
National Provider Identifier
1659444958
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
NC5090 Issued in NC
Practice address
Suite 812 a Vernon Park Mall
Kinston, NC 28504
Phone
(252) 522-1333
Fax
(252) 527-9321
NPI assigned
Nov 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 NC5090 NC Primary

Addresses

Primary practice location

Suite 812 a Vernon Park Mall
Kinston, NC 28504

Mailing address

Suite 812 a Vernon Park Mall
Kinston, NC 28504
Phone (252) 522-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160301002003 NC Order and Referring Only - DentistPractitioner - Dentist 2668777509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC5090NCMDGeneral Practice Dentistry
5090NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659444958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUITE 812 A VERNON PARK MALL",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "28504",
            "telephone_number": "252-522-1333",
            "fax_number": "252-527-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUITE 812 A VERNON PARK MALL",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "28504",
            "telephone_number": "252-522-1333",
            "fax_number": "252-527-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "TOMMIE",
        "middle_name": "HAROLD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "NC5090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

Verify at the official NPI Registry.