NPIMap

Organization Active NPI

Lane & Associates XV DDS PA

Doing business as Sanford Dental Care

  • General Practice Dentistry
  • Sanford, NC
National Provider Identifier
1902950769
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4785 Issued in NC
Legal business name
LANE & ASSOCIATES XV DDS PA
Doing business as
Sanford Dental Care
Practice address
2617 S Horner Blvd
Sanford, NC 27332-8032
Phone
(919) 774-1993
Fax
(919) 774-0580
NPI assigned
Jan 22, 2007
Last updated
Jun 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Alicia Duffy
Title
Credentialing Manager
Phone
(919) 295-2757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4785 NC Primary

Addresses

Primary practice location

2617 S Horner Blvd
Sanford, NC 27332-8032

Mailing address

2617 S Horner Blvd
Sanford, NC 27332-8032
Phone (919) 774-1993

Other identifiers 2

IdentifierTypeStateIssuer
89016TFMedicaidNC
016YGOtherNCBCBS-NC HEALTHCHOICE

Other names 1

  • Sanford Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

2617 S Horner Blvd
Sanford, NC 27332
Phone (919) 295-2757

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1902950769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 S HORNER BLVD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273328032",
            "telephone_number": "919-774-1993",
            "fax_number": "919-774-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 S HORNER BLVD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273328032",
            "telephone_number": "919-774-1993",
            "fax_number": "919-774-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANE & ASSOCIATES XV DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "919-295-2757"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016TF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC HEALTHCHOICE",
            "identifier": "016YG",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.