Individual provider Active NPI

Lorenza An-Jia Donnelly, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Chapel Hill, NC
National Provider Identifier
1962991307
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
11340 Issued in NC
Practice address
149 Brauer Hall CB#7450
Chapel Hill, NC 27599-0001
Phone
(919) 537-3944
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 11340 NC Primary

Addresses

Primary practice location

149 Brauer Hall CB#7450
Chapel Hill, NC 27599-0001

Mailing address

1104 Vermillion Dr
Durham, NC 27713-8231
Phone (510) 579-8825

Other names 1

  • Dr. Lorenza An-Jia Ayala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180730003323 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5597013151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11340NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
K. Kevin Neshat, DDS, MD, PA Past Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ldonnelly439082@direct.unc.nchie.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1962991307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 VERMILLION DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138231",
            "telephone_number": "510-579-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 BRAUER HALL CB#7450",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001",
            "telephone_number": "919-537-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "LORENZA",
        "middle_name": "AN-JIA",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "11340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORENZA",
            "last_name": "AYALA",
            "middle_name": "AN-JIA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.