Phillip Oliver Lance, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30.023052 Issued in OH

Practice address

BLDG 2441 21St Street
U S Army Dentac
Fort Campbell, KY 42223-5369

Phone

(270) 798-8614

Fax

(270) 798-8633

NPI assigned

Sep 2, 2009

Last updated

Sep 2, 2009By 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

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Miami Valley Smiles of Hamilton LLC

  • Dental Clinic/Center
  • Hamilton, OH
  • NPI 1174407506
  NPD Authorized official

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1780817072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "U S ARMY DENTAC",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235369",
            "telephone_number": "270-798-8614",
            "fax_number": "270-798-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "U S ARMY DENTAC",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235369",
            "telephone_number": "270-798-8614",
            "fax_number": "270-798-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCE",
        "first_name": "PHILLIP",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Kwon
• Vickie Lacy
• Marie-Helene Lai Lam
• Robert Eberle Lajeret II, RN
• Brandon Lami, PA-C
• Megan Pritchett Landre
• Christopher Lee Lange, M.D.
• Jennifer Travis Lange, M.D.
• Alexander Lanigan, M.D.
• Carleen Frances Laplant, DPT, ATC, CSCS, TSAC

• Dentist in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.