Individual provider Active NPI

Robert Lance Lerman, DMD

  • Pediatric Dentistry
  • Ansonia, CT
National Provider Identifier
1659499440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5120 Issued in CT
Practice address
497 Main St
Ansonia, CT 06401-2308
Phone
(203) 735-4701
Fax
(203) 736-9443
NPI assigned
Mar 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Pediatric Dentistry 1223P0221X 5120 CT Primary

Addresses

Primary practice location

497 Main St
Ansonia, CT 06401-2308

Mailing address

497 Main St
Ansonia, CT 06401-2308
Phone (203) 735-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150710000951 CT Order and Referring Only - DentistPractitioner - Dentist 7113239708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5120CTMDNurse Practitioner

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659499440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 MAIN ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012308",
            "telephone_number": "203-735-4701",
            "fax_number": "203-736-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 MAIN ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012308",
            "telephone_number": "203-735-4701",
            "fax_number": "203-736-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERMAN",
        "first_name": "ROBERT",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "5120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ansonia, CT

Sources for this page

Verify at the official NPI Registry.