David Michael Long, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

102446 Issued in CA

Practice address

78461 Highway 111
La Quinta, CA 92253

Phone

(760) 861-9599

NPI assigned

Apr 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1225457161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46261 GOLDEN ROD LN",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922605585",
            "telephone_number": "504-289-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78461 HIGHWAY 111",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "92253",
            "telephone_number": "760-861-9599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46261 Golden Rod Ln",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922605585",
            "country_code": "US",
            "telephone_number": "504-289-5689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "102446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Live Life Home Health LLC
• Live Well Naturopathic Clinic, a Professional Corporation
• Emilea Marie Lockhart
• Jessica Noel Lomeli
• Diana Londono
• Dennis R. Long, M.D.
• Toni Lorraine Long, MD
• Fernanda Aichel Lopez Siqueiros
• Patrice Jacqueline Lopez-Dowrey
• Jasmin Lopez

• Periodontics in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.