Active NPI
Jerold Hayes Lipson, DDS MS
- Periodontics
- Palo Alto, CA
National Provider Identifier
1235270554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 19924
- Practice address
- 680 University Av
Palo Alto, CA 94301 - Phone
- (650) 328-6120
- Fax
- (650) 328-1545
- NPI assigned
- Feb 9, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 19924 | CA | Primary |
Addresses
Primary practice location
680 University Av
Palo Alto, CA 94301
Mailing address
680 University Av
Palo Alto, CA 94301
Phone (650) 328-6120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19924 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235270554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 UNIVERSITY AV",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94301",
"telephone_number": "650-328-6120",
"fax_number": "650-328-1545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 UNIVERSITY AV",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94301",
"telephone_number": "650-328-6120",
"fax_number": "650-328-1545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPSON",
"first_name": "JEROLD",
"middle_name": "HAYES",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "19924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- 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.