Active NPI
Michael C. Li, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Temecula, CA
National Provider Identifier
1073950747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 63355
- Practice address
- 29560 Rancho California Rd Ste 100
Temecula, CA 92591-5294 - Phone
- (617) 834-2683
- NPI assigned
- Jun 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 63355 | CA | Primary |
Addresses
Primary practice location
29560 Rancho California Rd Ste 100
Temecula, CA 92591-5294
Mailing address
PO Box 2159
Temecula, CA 92593-2159
Phone (617) 834-2683
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150813010960 | CA | Order and Referring Only - Other (Physician) | 3375858756 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63355 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1073950747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2159",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925932159",
"telephone_number": "617-834-2683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29560 RANCHO CALIFORNIA RD STE 100",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925915294",
"telephone_number": "617-834-2683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "MICHAEL",
"middle_name": "C.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-04",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "63355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.