Provider Demographics
NPI:1629045950
Name:LUMPKIN-JONES, LORI NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:NICOLE
Last Name:LUMPKIN-JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 BASSETT CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6422
Mailing Address - Country:US
Mailing Address - Phone:281-974-0629
Mailing Address - Fax:
Practice Address - Street 1:101 PARKLANE BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5521
Practice Address - Country:US
Practice Address - Phone:281-974-0629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000008257122300000X
KS602891223G0001X
TX284271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200268410AMedicaid
TX3163362Medicaid
KS9177274OtherDORAL
OK200035910AMedicaid