Individual provider Active NPI

Virgil R. Lungu Jr., DDS

  • General Practice Dentistry
  • Terre Haute, IN
National Provider Identifier
1790070670
Registry record updated Jun 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011679A Issued in IN
Practice address
1800 Fort Harrison Rd
Terre Haute, IN 47804-1413
Phone
(812) 466-6527
NPI assigned
Jun 18, 2011
Last updated
Jun 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2011

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 12011679A IN Primary

Addresses

Primary practice location

1800 Fort Harrison Rd
Terre Haute, IN 47804-1413

Mailing address

1090 Northchase Pkwy SE Ste 290
Marietta, GA 30067-6402
Phone (770) 916-5352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20161216000301 IN Order and Referring Only - DentistPractitioner - Dentist 2365722964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308355200000",
    "number": "1790070670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE STE 290",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676402",
            "telephone_number": "770-916-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FORT HARRISON RD",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478041413",
            "telephone_number": "812-466-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNGU",
        "first_name": "VIRGIL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-18",
        "last_updated": "2011-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011679A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.