MEDICARE: DR. JAMES PAUL LOTAKIS DDS, MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8651	NC

General Provider Information

NPI Number	:	1235271321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PAUL LOTAKIS DDS, MA

Provider Business Mailing Address
First Line	:	3201 VALENTINE LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28270-0686
Country	:	US
Telephone Number	:	704-458-7735
Fax Number	:

Provider Business Practice Location Address
First Line	:	6708 ALBEMARLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-3856
Country	:	US
Telephone Number	:	704-537-1990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	02/16/2012

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