Randall Keith Lout in Mesa - Pediatric Dentistry
Randall Keith Lout - NPI 1285697474
Randall Keith Lout is a Pediatric Dentistry in Mesa, Arizona. Randall Keith Lout practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Randall Keith Lout is 1285697474. The last update date is 2007-07-08.
Randall Keith Lout's current location address is 6239 E Brown Rd, Mesa, Arizona. You can contact this provider via phone number 4803963660 and fax number 4803963697. The mailing address for Randall Keith Lout is 6239 E Brown Rd, Mesa, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall Keith Lout |
|---|---|
| Address | 6239 E Brown Rd, Mesa, Arizona |
| Phone Number | 4803963660 |
| Fax Number | 4803963697 |
| Sole Proprietor | X |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1285697474 |
|---|---|
| Provider Enumeration Date | 2006-04-09 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 6239 E Brown Rd |
|---|---|
| City | Mesa |
| State | Arizona (AZ) |
| Post Code | 852054933 |
| Phone Number | 4803963660 |
| Fax Number | 4803963697 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 3911 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique identification code assigned to Randall Keith Lout by the Centers for Medicare & Medicaid Services?
The Randall Keith Lout has been issued the NPI (National Provider Identifier) 1285697474. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Randall Keith Lout's physical address?
The Randall Keith Lout is physically located at 6239 E Brown Rd, in the city of Mesa, AZ, with the postal code 852054933.
What is the Randall Keith Lout's specialty and taxonomy code?
The Randall Keith Lout's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1285697474 to Randall Keith Lout?
The Centers for Medicare & Medicaid Services originally issued the 1285697474 to Randall Keith Lout on 2006-04-09.
When was the information related to Randall Keith Lout most recently updated or refreshed?
The details pertaining to the Randall Keith Lout, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.