Individual provider Active NPI

Lizandre Belanger, DMD

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1073036901
Registry record updated Jul 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16411 Issued in TX
Practice address
2133 Pepperrell St
San Antonio, TX 78236-5313
Phone
(210) 292-0123
NPI assigned
Jul 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16411 TX Primary

Addresses

Primary practice location

2133 Pepperrell St
San Antonio, TX 78236-5313

Mailing address

302 E Josephine St Ste 3101
San Antonio, TX 78215-1193
Phone (830) 320-6583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16411TXMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500768000000",
    "number": "1073036901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 E JOSEPHINE ST STE 3101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151193",
            "telephone_number": "830-320-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 PEPPERRELL ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365313",
            "telephone_number": "210-292-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANGER",
        "first_name": "LIZANDRE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2017-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.