Provider Demographics
NPI:1427271949
Name:LANE, JAMES (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LANE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 WARD DR STE 203
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0579
Mailing Address - Country:US
Mailing Address - Phone:615-895-8445
Mailing Address - Fax:615-895-6396
Practice Address - Street 1:1826 WARD DR STE 203
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0579
Practice Address - Country:US
Practice Address - Phone:615-895-8445
Practice Address - Fax:615-895-6396
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1520354Medicaid