Provider Demographics
NPI:1841743283
Name:THOMAS J LOKENSGARD, DDS, PLLC
Entity Type:Organization
Organization Name:THOMAS J LOKENSGARD, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOKENSGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-338-5055
Mailing Address - Street 1:4095 MALLORY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8268
Mailing Address - Country:US
Mailing Address - Phone:615-481-4555
Mailing Address - Fax:
Practice Address - Street 1:4095 MALLORY LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8268
Practice Address - Country:US
Practice Address - Phone:615-481-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8768305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization