Provider Demographics
NPI:1689837577
Name:LOHR, JULIE ANN (DDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:LOHR
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 1:2918 HAMILTON BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-2414
Mailing Address - Country:US
Mailing Address - Phone:712-255-1163
Mailing Address - Fax:712-252-6157
Practice Address - Street 1:2918 HAMILTON BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-2414
Practice Address - Country:US
Practice Address - Phone:712-255-1163
Practice Address - Fax:712-252-6157
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA085691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0268888Medicaid