Lisa Marie Dickenson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33575 Issued in CA

Practice address

2485 Notre Dame Blvd
350
Chico, CA 95928-7161

Phone

(530) 343-5455

Fax

(530) 343-9357

NPI assigned

Nov 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Lisa Marie Willett Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A. Stephens Dental Inc.

  • Dental Clinic/Center
  • Durham, CA
  • NPI 1023577087
  NPD (past)

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

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083697759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 NOTRE DAME BLVD",
            "address_2": "STE 350",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287163",
            "telephone_number": "530-343-5455",
            "fax_number": "530-924-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 NOTRE DAME BLVD",
            "address_2": "350",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287161",
            "telephone_number": "530-343-5455",
            "fax_number": "530-343-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENSON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WILLETT",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• DHL Enterprises, LLC
• Dyan Diamond
• Adriana Valeria Diaz
• Ricardo Diaz II
• Victoria Raquell Diaz
• Garrett Dickinson, LVN
• Ann Lusk Dickman, RN
• Jonathan Mark Dickman
• Brian Diep, DDS
• Dat Quoc Diep, PHARMD

• General Practice Dentistry in Chico, CA
• Providers in Chico, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.