Individual provider Active NPI

Cheryl Ann Lemelle, D.D.S.

  • Dentist
  • Jamaica, NY
National Provider Identifier
1316076763
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049162-1 Issued in NY
Practice address
11211 179TH St
Jamaica, NY 11433-4125
Phone
(718) 297-3410
NPI assigned
Mar 3, 2007
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
Dentist 122300000X 049162-1 NY Primary

Addresses

Primary practice location

11211 179TH St
Jamaica, NY 11433-4125

Mailing address

11211 179TH St
Jamaica, NY 11433-4125
Phone (718) 297-3410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160429000154 NY Order and Referring Only - DentistPractitioner - Dentist 1951600766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049162-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316076763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 179TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114334125",
            "telephone_number": "718-297-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 179TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114334125",
            "telephone_number": "718-297-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMELLE",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049162-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.