Individual provider Active NPI

Lisa Caroline D'Affronte, D.D.S.

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1245585702
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15324 Issued in MD
Practice address
650 W Baltimore St
Baltimore, MD 21201-1510
Phone
(410) 706-3194
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15324 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

650 W Baltimore St
Baltimore, MD 21201-1510

Mailing address

650 W Baltimore St
Baltimore, MD 21201-1510
Phone (410) 706-3194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20121016000227 MD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0547410201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15324MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1245585702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AFFRONTE",
        "first_name": "LISA",
        "middle_name": "CAROLINE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15324",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.