Adelheid Nerisa Limansubroto, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

104987 Issued in CA

Practice address

1104 N Chinowth St
Visalia, CA 93291-4113

Phone

(559) 625-9043

NPI assigned

Jul 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1595116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595116800000",
    "number": "1134737836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 S LOVERS LN APT E",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 N CHINOWTH ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914113",
            "telephone_number": "559-625-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMANSUBROTO",
        "first_name": "ADELHEID NERISA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-19",
        "last_updated": "2020-07-19",
        "certification_date": "2020-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "104987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Google",
            "affiliation": "N",
            "address_1": "1104 N Chinowth St",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932914113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Stevens Liddle, PHARMD
• Lifecare Solutions Inc
• Katelyn Lightner
• Jihoon Lim, MD
• Estefania Lima Duran
• Limbitless LLC
• Limbitless, Inc.
• Limbology, LLC
• Lincare Inc.
• Autumn A Lindberg, LMFT

• Endodontics in Visalia, CA
• Providers in Visalia, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2020; 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.