Lane Slack, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12512 Issued in TN

Practice address

2719 Kingston Pike
Knoxville, TN 37919-4620

Phone

(865) 524-1265

NPI assigned

Jun 18, 2024

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Pablo a. Foncea, DMD, PC

  • Dental Clinic/Center
  • Knoxville, TN
  • NPI 1194249698
  NPD

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1992548846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 MCNABB AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379203043",
            "telephone_number": "615-489-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194620",
            "telephone_number": "865-524-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Dillon Skipper
• Linda Johnson Sklar, FNP
• David Richard Skocy III
• Kelly Skubisz, PH.D.
• Skyway Family Care
• Stephanie Dawn Slack, MSW
• Joshua Lee Slager, NP
• Carly Stapleton Slagle, RD
• Jennifer Slagle, BA
• Katelyn Slagle

• All providers in Knoxville, TN
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.