Individual provider Active NPI

Lyndi Levo Bach, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Santa Ana, CA
National Provider Identifier
1114930450
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
50007 Issued in CA
Practice address
1920 E 17TH St Ste 120
Santa Ana, CA 92705-8626
Phone
(949) 379-1516
NPI assigned
Aug 15, 2006
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 50007 CA Primary

Addresses

Primary practice location

1920 E 17TH St Ste 120
Santa Ana, CA 92705-8626

Mailing address

17575 Chatham Dr
Tustin, CA 92780-2302
Phone (714) 348-2684

Other names 1

  • Dr. Lyndi Le Vo Former name

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
I20150921000481 CA Order and Referring Only - DentistPractitioner - Dentist 4284941410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
50007CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1114930450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17575 CHATHAM DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802302",
            "telephone_number": "714-348-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E 17TH ST STE 120",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058626",
            "telephone_number": "949-379-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "LYNDI",
        "middle_name": "LEVO",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "50007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDI",
            "last_name": "VO",
            "middle_name": "LE",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.