Lia Palmacci, DMD
Individual provider Active NPI Dentist · Beale Afb, CA
NPI 1134867732 · NPPES record last updated Aug 23, 2023
Key facts
- NPI
- 1134867732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DEN.00205324 (CO)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1905 - Phone
- (530) 634-2941
- NPI assigned
- May 24, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205324 | CO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN.00205324 | CO | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Other providers in Beale Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.