Active NPI
M. Isabel Lyra-Leeds, D.D.S.
- General Practice Dentistry
- New York, NY
National Provider Identifier
1356436067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 039884-1
- Practice address
- 630 5TH Ave
Suite 1801
New York, NY 10111-0100 - Phone
- (212) 541-4010
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 039884-1 | NY | Primary |
Addresses
Primary practice location
630 5TH Ave
Suite 1801
New York, NY 10111-0100
Mailing address
630 5TH Ave
Suite 1801
New York, NY 10111-0100
Phone (212) 541-4010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039884-1 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356436067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 5TH AVE",
"address_2": "SUITE 1801",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101110100",
"telephone_number": "212-541-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 5TH AVE",
"address_2": "SUITE 1801",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101110100",
"telephone_number": "212-541-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYRA-LEEDS",
"first_name": "M. ISABEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "039884-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
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.