Individual provider Active NPI

Lasaundra C Estelle, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1124020235
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052419 Issued in NY
Practice address
20 E 46TH St
Ste 400
New York, NY 10017-2417
Phone
(212) 426-3790
Fax
(212) 682-3501
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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 052419 NY Primary

Addresses

Primary practice location

20 E 46TH St
Ste 400
New York, NY 10017-2417

Mailing address

20 E 46TH St
Ste 400
New York, NY 10017-2417
Phone (212) 426-3790

Other identifiers 1

IdentifierTypeStateIssuer
02685610MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1124020235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E 46TH ST",
            "address_2": "STE 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100172417",
            "telephone_number": "212-426-3790",
            "fax_number": "212-682-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E 46TH ST",
            "address_2": "STE 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100172417",
            "telephone_number": "212-426-3790",
            "fax_number": "212-682-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTELLE",
        "first_name": "LASAUNDRA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02685610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.