Individual provider Active NPI

Lilian Custodio Patsey, DDS

  • Dentist
  • Lexington, KY
National Provider Identifier
1376370064
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11237 Issued in KY
Practice address
740 S Limestone Kentucky Clinic E214
Lexington, KY 40536-0284
Phone
(859) 323-5500
Fax
(859) 323-0001
NPI assigned
Sep 17, 2024
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11237 KY Primary
Orofacial Pain Dentistry 1223X2210X 11237 KY

Addresses

Primary practice location

740 S Limestone Kentucky Clinic E214
Lexington, KY 40536-0284

Mailing address

740 S Limestone Kentucky Clinic E214
Lexington, KY 40536-0284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250123001405 KY Practitioner - Dentist 6901335793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11237KYMDOrofacial Pain Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky Dentist CurrentSince Dec 15, 2024 Accepting new patients
University of Kentucky CurrentSince Dec 15, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1376370064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE KENTUCKY CLINIC E214",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE KENTUCKY CLINIC E214",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284",
            "telephone_number": "859-323-5500",
            "fax_number": "859-323-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTODIO PATSEY",
        "first_name": "LILIAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "11237",
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "KY",
            "license": "11237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.