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General NPI Number Information
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NPI Number | 1225563646
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Entity Type | Individual
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Provider Name | LORYN WILSON DASS MD
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Gender | Female
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 1200 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1004
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Country | US
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Telephone | 336-832-8064
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Fax | 336-832-7893
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Provider Business Mailing Address
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Address Line | 200 TRENT DR M148 GREEN ZONE BOX 3951 DAVISON BUILDING
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City | DURHAM
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State | NC
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Zip | 27710-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2021-01234
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD048199
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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