MEDICARE: LEXINGTON HEIGHTS DENTAL

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

General Provider Information

NPI Number	:	1972616928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXINGTON HEIGHTS DENTAL

Provider Business Mailing Address
First Line	:	4587 CEDAR HILLS DRIVE
Second Line	:
City	:	CEDAR HILLS
State	:	UT
Zip	:	84062
Country	:	US
Telephone Number	:	801-756-2006
Fax Number	:	801-756-0821

Provider Business Practice Location Address
First Line	:	4587 CEDAR HILLS DRIVE
Second Line	:
City	:	CEDAR HILLS
State	:	UT
Zip	:	84062
Country	:	US
Telephone Number	:	801-756-2006
Fax Number	:	801-756-0821

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JOHN R LOHNER
Credential	:	DDS
Telephone Number	:	801-756-2006

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	05/06/2008

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