Brock Jason Lorenz, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

61270 Issued in CA

Practice address

4636 Lee Ave
La Mesa, CA 91942-6939

Phone

(619) 804-8339

NPI assigned

May 27, 2013

Sex

Male

Sole proprietor

Yes

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 CA

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

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Pouldar Kimia and Lorenz Dental Partnership

  • General Practice Dentistry
  • Sherman Oaks, CA
  • NPI 1639624463

  Periodontics

  Medicare reassignment NPD

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

{
    "created_epoch": "1369612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1861839243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 LEE AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426939",
            "telephone_number": "619-804-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 LEE AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426939",
            "telephone_number": "619-804-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "BROCK",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-27",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "61270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lopez
• Jennifer Jazmin Lopez
• Natalie Luisa Lopez
• Veronica Marlene Lopez, PHARM D
• Anna Lorentzen
• Anna Sophia Love, OT
• Loving Heart Assisted Living
• Marissa Lovio, MD
• Low Dental, a.P.C.
• Jennifer Low

• Periodontics in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.