Provider Demographics
NPI:1134103484
Name:LOWMAN, DENNIS GENE (OD)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GENE
Last Name:LOWMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56970 YUCCA TRL
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-3753
Mailing Address - Country:US
Mailing Address - Phone:760-228-2020
Mailing Address - Fax:760-369-2020
Practice Address - Street 1:56970 YUCCA TRL
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3753
Practice Address - Country:US
Practice Address - Phone:760-228-2020
Practice Address - Fax:760-369-2020
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8787152W00000X
CAOPT8787T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6685580001OtherNORIDIAN MEDICARE REGION D
CAGSD004460OtherMEDICAID GROUP NUMBER
CA1245517804OtherGROUP NPI
CASD0087870Medicaid
CAFU077AOtherMEDICARE GROUP NUMBER
CASD0087870Medicaid
CA1124224589Medicare NSC
CA6685580001Medicare NSC
CA1245517804OtherGROUP NPI
CAGSD004460OtherMEDICAID GROUP NUMBER
CAU25818Medicare UPIN