Shane Lu, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

9969 Issued in NC

Practice address

242 N Talbert Blvd
Lexington, NC 27292

Phone

(336) 248-6790

Fax

(336) 248-6790

NPI assigned

Jul 29, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1952719353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 N TALBERT BLVD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272924143",
            "telephone_number": "336-248-6790",
            "fax_number": "336-248-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N TALBERT BLVD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "27292",
            "telephone_number": "336-248-6790",
            "fax_number": "336-248-6790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 MacGregor Downs Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278345925",
            "country_code": "US",
            "telephone_number": "252-737-7096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "150987",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wendy Michelle Lyerly, RN
• M Medical NC PLLC
• Kelli Claire Mackie, OTR/L

• Dentist in Lexington, NC
• Providers in Lexington, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.