Provider Demographics
NPI:1649578402
Name:LENTZ ENTERPRISES, LLC
Entity Type:Organization
Organization Name:LENTZ ENTERPRISES, LLC
Other - Org Name:LENTZ EYE CARE & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-634-2020
Mailing Address - Street 1:670 E 47TH ST S
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67216-1769
Mailing Address - Country:US
Mailing Address - Phone:316-613-3400
Mailing Address - Fax:316-613-3409
Practice Address - Street 1:670 E 47TH ST S
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67216-1769
Practice Address - Country:US
Practice Address - Phone:316-613-3400
Practice Address - Fax:316-613-3409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1814152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS515481Medicare PIN
KS0853440004Medicare NSC