Individual provider Active NPI

Peter Lo, D.M.D.

  • Dentist
  • Flushing, NY
National Provider Identifier
1912102898
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
053286 Issued in NY
Practice address
13347 Sanford Ave Ste C1B
Flushing, NY 11355-5870
Phone
(718) 888-8828
NPI assigned
Jun 19, 2007
Last updated
May 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053286 NY Primary

Addresses

Primary practice location

13347 Sanford Ave Ste C1B
Flushing, NY 11355-5870

Mailing address

20A Deepdale Dr
Huntington Station, NY 11746-4220

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
053286NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Lo DMD, P.C. CurrentSince May 16, 2022 Accepting new patients

Locations

13347 Sanford Ave
Ste C1B
Flushing, NY 11355
Phone (718) 888-8828

Interoperability endpoints

  • Direct secure messaging: peter.lo.p1@direct.premierhealthcare.nextgenshare.com

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1912102898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20A DEEPDALE DR",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13347 SANFORD AVE STE C1B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555870",
            "telephone_number": "718-888-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "PETER",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

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