Mike Li, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

52636 Issued in CA

Practice address

1108 Vicente St Ste 104
San Francisco, CA 94116-3042

Phone

(415) 753-6161

Fax

(415) 753-0208

NPI assigned

Jan 29, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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.

• Mike Li, D.D.S., Inc.

  • Dental Clinic/Center
  • San Francisco, CA
  • NPI 1245477686
  NPD (past) Authorized official

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1124205455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 VICENTE ST STE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941163042",
            "telephone_number": "415-753-6161",
            "fax_number": "415-753-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 VICENTE ST STE 104",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941163042",
            "telephone_number": "415-753-6161",
            "fax_number": "415-753-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "MIKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "2023547",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucy Li
• Mankit Li, PSY.D.
• Marsha Y Li, PHARMD
• Michael Li
• Michelle L Li, M.D.
• Mingzhen Li
• Molong Li, M.D.
• Nan Li, L.AC
• Norberto Li, D.D.S.
• PO-Yi Jonathan Li

• Dentist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.

Verify at the official NPI Registry.