Individual provider Active NPI

Lisa Allyn Slingbaum, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Key West, FL
National Provider Identifier
1144429242
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
16854 Issued in FL
Practice address
3716 N Roosevelt Blvd
Suite 6
Key West, FL 33040-4533
Phone
(305) 296-8665
Fax
(305) 294-0055
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 16854 FL Primary

Addresses

Primary practice location

3716 N Roosevelt Blvd
Suite 6
Key West, FL 33040-4533

Mailing address

3716 N Roosevelt Blvd
Suite 6
Key West, FL 33040-4533
Phone (305) 296-8665

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

State licenses

LicenseStateTypeSpecialty
16854FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1144429242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 N ROOSEVELT BLVD",
            "address_2": "SUITE 6",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404533",
            "telephone_number": "305-296-8665",
            "fax_number": "305-294-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 N ROOSEVELT BLVD",
            "address_2": "SUITE 6",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404533",
            "telephone_number": "305-296-8665",
            "fax_number": "305-294-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLINGBAUM",
        "first_name": "LISA",
        "middle_name": "ALLYN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "16854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.