1881962611 NPI number — DR. HEATHER NICOLE LOWRY DDS

Table of content: DR. HEATHER NICOLE LOWRY DDS (NPI 1881962611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881962611 NPI number — DR. HEATHER NICOLE LOWRY DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOWRY
Provider First Name:
HEATHER
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SORBER
Provider Other First Name:
HEATHER
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1881962611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2512 E. MARKET ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44483
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-394-6660
Provider Business Mailing Address Fax Number:
330-394-7422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2512 E. MARKET ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-394-6660
Provider Business Practice Location Address Fax Number:
330-394-7422
Provider Enumeration Date:
12/07/2011

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: 122300000X , with the licence number:  30-023460 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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