Elizabeth Ly, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS104926 Issued in CA

Practice address

17010 Red Hill Ave Ste D
Irvine, CA 92614-5626

Phone

(949) 975-0150

NPI assigned

May 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1316504400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22992 LOVIOS",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912133",
            "telephone_number": "714-383-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17010 RED HILL AVE STE D",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "949-975-0150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 N Wayte Ln Ste 2500",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012124",
            "country_code": "US",
            "telephone_number": "559-459-6927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2015 Hamilton St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181046471",
            "country_code": "US",
            "telephone_number": "610-616-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "ELIZABETH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042750",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS104926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc.
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Cong T Ly
• Coral Ly
• Jennifer Ly
• Thanh-Lan Ly, NP-C
• Elizabeth Joy Lyche
• Lyfseeker, Inc
• Alexa Lyon

• General Practice Dentistry in Irvine, CA
• Providers in Irvine, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.