Active NPI
Ray A. Lyons, DDS,FADPD, DABSCD
- General Practice Dentistry
- Albuquerque, NM
National Provider Identifier
1396720827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DD1302
- Practice address
- 7905 Marble Ave NE
Albuquerque, NM 87110-7886 - Phone
- (505) 232-5710
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
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 | DD1302 | NM | Primary |
Addresses
Primary practice location
7905 Marble Ave NE
Albuquerque, NM 87110-7886
Mailing address
PO Box 1269
Los Lunas Community Program
Los Lunas, NM 87031-1269
Phone (505) 222-0919
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8808 | Other | NM | DELTA DENTAL |
| 0007343702 | Other | NM | AETNA |
| 8942 | Other | NM | BC/BS |
| S0014741010 | Other | NM | HCH ADMINISTRATION |
| 631452 | Other | NM | UNITED CONCORDIA |
| 0004093 | Other | NM | DORAL DENTAL |
| K8599 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160226000234 | NM | Order and Referring Only - Other (Physician) | 1153626379 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD1302 | NM | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284508800000",
"number": "1396720827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1269",
"address_2": "LOS LUNAS COMMUNITY PROGRAM",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "870311269",
"telephone_number": "505-222-0919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7905 MARBLE AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871107886",
"telephone_number": "505-232-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "RAY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "DDS,FADPD, DABSCD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2010-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "DD1302",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "8808",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0007343702",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "8942",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCH ADMINISTRATION",
"identifier": "S0014741010",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "631452",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL",
"identifier": "0004093",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "K8599",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.