Healthcare Provider Details

I. General information

NPI: 1366146557
Provider Name (Legal Business Name): LORI ANN GOSSETT DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 W HERMOSA DR
ARTESIA NM
88210-3119
US

IV. Provider business mailing address

2520 W HERMOSA DR
ARTESIA NM
88210-3119
US

V. Phone/Fax

Practice location:
  • Phone: 575-914-2966
  • Fax:
Mailing address:
  • Phone: 575-914-2966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDB-2025-0430
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: