Lisa Marie Bezenek, HYGIENIST

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

719 Issued in AK

Practice address

2960 Tongass Ave
Suite 403
Ketchikan, AK 99901-5742

Phone

(907) 228-4902

Fax

(907) 228-5256

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lisa Marie Bezenek Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205968864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "address_2": "SUITE 403",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742",
            "telephone_number": "907-228-4902",
            "fax_number": "907-228-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "address_2": "SUITE 403",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742",
            "telephone_number": "907-228-4902",
            "fax_number": "907-228-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZENEK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "AK",
            "license": "719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DENTAL HYGIENIST",
            "identifier": "719",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HYGIENIST LICENSED TO ADM",
            "identifier": "398",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BEZENEK",
            "middle_name": "MARIE",
            "credential": "HYGIENIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Faylene Benito
• Steven Bennett, LMT
• Jennifer Lynn Bergen, RN
• Trisha Bermudez
• Sandra Marie Beyer, PHARMICIST
• Sean Bhagat, M.D.
• Hannah Bigger
• Matthew Tobias Andrew Blair-Isaacs
• Mayjesstik Blair-Isaacs
• Elias Antonio Blair

• Dental Hygienist in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Dental Hygienist in Alaska

• 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.