Lisa Duckles

Primary specialty

DentistTaxonomy code 122300000X

License

DE61474642 Issued in WA

Practice address

505 Cedar Ave Ste C1
Marysville, WA 98270-4561

Phone

(360) 659-3232

NPI assigned

Jul 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1134737505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CEDAR AVE STE C1",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CEDAR AVE STE C1",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704561",
            "telephone_number": "360-659-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Route 137",
            "address_purpose": "LOCATION",
            "city": "East Harwich",
            "state": "MA",
            "postal_code": "026452153",
            "country_code": "US",
            "telephone_number": "508-432-8686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUCKLES",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858758",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61474642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Dirks, N.D.
• Austin Taylor Dix
• Kimberly DO
• Dr. Seongwon Choi PLLC.
• Andrea Drown, DO
• Tracy Lynn Duffy, L.M.P, C.H.P
• Lynda Luu Duong, L.AC
• Dan R Duval, MA LCMHC
• Karen E Duval, LICSW
• Amy Lee Dye, LMP

• Dentist in Marysville, WA
• Providers in Marysville, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.