1003898008 NPI number — DR. CAROL ANN LORENTE DMD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003898008 NPI number — DR. CAROL ANN LORENTE DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LORENTE
Provider First Name:
CAROL
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003898008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BEDFORD VA HOSPITAL
Provider Second Line Business Mailing Address:
DENTAL DEPT., MAILSTOP 160, 200 SPRINGS RD.
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-687-2469
Provider Business Mailing Address Fax Number:
781-687-3967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BEDFORD VA HOSPITAL
Provider Second Line Business Practice Location Address:
DENTAL DEPT., MAILSTOP 160, 200 SPRINGS RD.
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-687-2469
Provider Business Practice Location Address Fax Number:
781-687-3967
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 204E00000X , with the licence number:  14505 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: X04567 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 794892 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".




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