Levi Samuel Palmer, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

52667 Issued in CA

Practice address

7275 Adobe Creek Dr
Kelseyville, CA 95451-8008

Phone

(707) 263-0629

Fax

(707) 263-0629

NPI assigned

Apr 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174740898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7275 ADOBE CREEK DR",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518008",
            "telephone_number": "707-263-0629",
            "fax_number": "707-263-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 ADOBE CREEK DR",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518008",
            "telephone_number": "707-263-0629",
            "fax_number": "707-263-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "LEVI",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "52667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "52667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "52667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blancandrea Quetzali Molina, LPCC
• Zabdy Martinez Neria, MSW (LCSW 135934)
• North Coast Faculty Medical Group (Sutter Medical Group of the Redwoods)
• Nurturing Healthy Minds
• Ian Palmer, ASW
• Carolina Rondas Pimenta, LMFT
• Alina Poenaru
• Sharon Prill
• Psychiatric Care Medical Corporation
• Crystal Rodrigues

• Pediatric Dentistry in Kelseyville, CA
• Providers in Kelseyville, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.