Individual provider Active NPI

Lisa Marie Salisbury, D.D.S.

  • Dentist
  • Richmond, IL
National Provider Identifier
1386893220
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019024483 Issued in IL
Practice address
10015 Main Street
Richmond, IL 60071
Phone
(815) 678-4551
Fax
(815) 678-4555
NPI assigned
Sep 16, 2008
Last updated
Sep 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019024483 IL Primary

Addresses

Primary practice location

10015 Main Street
Richmond, IL 60071

Mailing address

PO Box 532
Richmond, IL 60071-0532
Phone (815) 678-4551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150417001296 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8729306949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles by Design Group LTD Past Accepting new patients

Organizations & group practices 1

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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1386893220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532",
            "city": "RICHMOND",
            "state": "IL",
            "postal_code": "600710532",
            "telephone_number": "815-678-4551",
            "fax_number": "815-678-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10015 MAIN STREET",
            "city": "RICHMOND",
            "state": "IL",
            "postal_code": "60071",
            "telephone_number": "815-678-4551",
            "fax_number": "815-678-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALISBURY",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019024483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IL

Sources for this page

Verify at the official NPI Registry.