Individual provider Active NPI

Michael J Lorenz II, DDS

  • Dentist
  • Festus, MO
National Provider Identifier
1770077794
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2018021977 Issued in MO
Practice address
112 S 2ND St
Festus, MO 63028-2201
Phone
(636) 321-0110
Fax
(636) 285-8988
NPI assigned
Jun 22, 2018
Last updated
Jun 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2018021977 MO Primary

Addresses

Primary practice location

112 S 2ND St
Festus, MO 63028-2201

Mailing address

227 Main St
Festus, MO 63028-1952
Phone (636) 931-2700

Other practice location 1

4 Hickory Ridge Rd Ste 600
Hillsboro, MO 63050-5117
Phone (636) 481-6040

Other practice location 2

4300 Gravois Rd
House Springs, MO 63051-2304
Phone (636) 321-0150

Other practice location 3

849 Jeffco Blvd
Arnold, MO 63010-1409
Phone (636) 287-0440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2018021977MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc Past Accepting new patients

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": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1770077794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952",
            "telephone_number": "636-931-2700",
            "fax_number": "636-931-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S 2ND ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282201",
            "telephone_number": "636-321-0110",
            "fax_number": "636-285-8988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Hickory Ridge Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "MO",
            "postal_code": "630505117",
            "country_code": "US",
            "telephone_number": "636-481-6040",
            "fax_number": "636-797-5660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Gravois Rd",
            "address_purpose": "LOCATION",
            "city": "House Springs",
            "state": "MO",
            "postal_code": "630512304",
            "country_code": "US",
            "telephone_number": "636-321-0150",
            "fax_number": "636-375-5157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "849 Jeffco Blvd",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630101409",
            "country_code": "US",
            "telephone_number": "636-287-0440",
            "fax_number": "636-285-8988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2018021977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.