Individual provider Active NPI

Sol Lee Fleming, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1083711154
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
B33705 Issued in CA
Practice address
1857 Cable St
San Diego, CA 92107-3122
Phone
(619) 224-3391
Fax
(619) 224-3205
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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 B33705 CA Primary

Addresses

Primary practice location

1857 Cable St
San Diego, CA 92107-3122

Mailing address

1857 Cable St
San Diego, CA 92107-3122
Phone (619) 224-3391

Other identifiers 1

IdentifierTypeStateIssuer
770619350OtherCATAX ID #

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528002097 CA Order and Referring Only - DentistPractitioner - Dentist 6002136207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B33705CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1083711154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073122",
            "telephone_number": "619-224-3391",
            "fax_number": "619-224-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1857 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073122",
            "telephone_number": "619-224-3391",
            "fax_number": "619-224-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "SOL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "B33705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "770619350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.