Basic Information
| Provider Information | |||||||||
| NPI: | 1457381212 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANTZ | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5074 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571175074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | 7013648906 | ||||||||
| Practice Location | |||||||||
| Address1: | 1720 UNIVERSITY DR S | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581034940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012804140 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 9361 | ND | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 68G22LA | 01 | ND | MNBS # | OTHER | 23410 | 01 | ND | NDBS # | OTHER | 512438700 | 05 | ND | MEDICAID | 0901155 | 01 | ND | MEDICA # | OTHER | 0901156 | 01 | ND | MEDICA # | OTHER | 72G02LA | 01 | ND | MNBS # | OTHER | 0901241 | 01 | ND | MEDICA # | OTHER | 12522 | 05 | ND | MEDICAID | 1881620 | 01 | ND | AMERICA'S PPO/ARAZ # | OTHER | HP39036 | 01 | ND | HEALTHPARTNERS # | OTHER | DA9051035028 | 01 | ND | PREFERRED ONE # | OTHER | 23702 | 01 | ND | NDBS # | OTHER | DA9011035028 | 01 | ND | PREFERRED ONE # | OTHER |