Provider Demographics
NPI:1962991307
Name:DONNELLY, LORENZA AN-JIA (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:LORENZA
Middle Name:AN-JIA
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:DR
Other - First Name:LORENZA
Other - Middle Name:AN-JIA
Other - Last Name:AYALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1104 VERMILLION DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8231
Mailing Address - Country:US
Mailing Address - Phone:510-579-8825
Mailing Address - Fax:
Practice Address - Street 1:149 BRAUER HALL CB#7450
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-537-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11340204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery