Lori Johnson Petree, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011603 Issued in AZ

Practice address

1213 N Main St
Fuquay Varina, NC 27526-2616

Phone

(910) 814-2944

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lane and Associates I DDS PA

  • General Practice Dentistry
  • Fuquay Varina, NC
  • NPI 1154336642
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1700938495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034416",
            "telephone_number": "336-722-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262616",
            "telephone_number": "910-814-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREE",
        "first_name": "LORI",
        "middle_name": "JOHNSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7541",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902H2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcy Alana Person
• Courtney Pestovich, LCMHCA, CRC
• Sally A Peters, CSW
• Bridget Ann Peterson, OTRL
• Alicia Ivana Peton, M.S., LCMHC
• Chante Dominique Pettiford, DPT
• Phoenix Partners NC
• Pinecrest Chiropractic PLLC
• Jordan Pittman
• Matthew Riggs Pittman

• General Practice Dentistry in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.