Individual provider Active NPI

Lois Rhee Ledesma, DDS

  • General Practice Dentistry
  • Palmdale, CA
National Provider Identifier
1184847931
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34547 Issued in CA
Practice address
2205 E Palmdale Blvd
Palmdale, CA 93550-1316
Phone
(661) 273-1333
Fax
(661) 273-1687
NPI assigned
Apr 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34547 CA Primary

Addresses

Primary practice location

2205 E Palmdale Blvd
Palmdale, CA 93550-1316

Mailing address

2205 E Palmdale Blvd
Palmdale, CA 93550-1316
Phone (661) 273-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130402000021 CA Practitioner - Oral Surgery 4284879826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fulbright Dental Group, PC General Practice CurrentSince Dec 19, 2015 Accepting new patients

Locations

5220 Pacific Concourse Dr
Ste 120
Los Angeles, CA 90045
Phone (310) 228-0396

1801 W Olympic Blvd
#1738
Pasadena, CA 91199

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184847931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935501316",
            "telephone_number": "661-273-1333",
            "fax_number": "661-273-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935501316",
            "telephone_number": "661-273-1333",
            "fax_number": "661-273-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "LOIS",
        "middle_name": "RHEE",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.