Lyly Fisher DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7067 Issued in WA

Legal business name

LYLY FISHER DDS PLLC

Practice address

406 Burnett Ave S
Renton, WA 98057-2551

Phone

(425) 271-5705

Fax

(425) 271-0165

NPI assigned

Jan 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lyly Fisher, DDSNPI 1134218274

Title

Owner, Dentist

Phone

(425) 271-5705

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lyly Fisher, DDS

  • Dentist
  • Renton, WA
  • NPI 1134218274
  NPD (past) Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174674915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 BURNETT AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572551",
            "telephone_number": "425-271-5705",
            "fax_number": "425-271-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BURNETT AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572551",
            "telephone_number": "425-271-5705",
            "fax_number": "425-271-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYLY FISHER DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "LYLY",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "425-271-5705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thanh Luu
• Deborah Luxem, RD
• Joann Ly, LMT
• Joan Lyke, RN
• Charles Nathaniel Lyles, LICSW
• Samantha Louise Lyman, OTD, OTR/L
• Larraine Jo-Anne Lynch, M.S.W., L.I.C.S.W.
• Natalia R Lynn
• Natalia Katherine Lyon
• Becky Lynn Lyons Dills, NP-C

• General Practice Dentistry in Renton, WA
• Providers in Renton, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.