Provider Demographics
NPI:1841418738
Name:LOMAN, SCOTT JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JEFFREY
Last Name:LOMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 LANCASTER DR NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4794
Mailing Address - Country:US
Mailing Address - Phone:503-581-9419
Mailing Address - Fax:
Practice Address - Street 1:1160 LIBERTY ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4143
Practice Address - Country:US
Practice Address - Phone:503-366-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA321221223G0001X
OR92191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice