Eric Street Lewis, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2494-89 Issued in MS

Practice address

212 Rawls Dr
McComb, MS 39648-2870

Phone

(601) 249-0045

Fax

(601) 249-0105

NPI assigned

Jan 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1396920252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 RAWLS DR",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482870",
            "telephone_number": "601-249-0045",
            "fax_number": "601-249-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 RAWLS DR",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482870",
            "telephone_number": "601-249-0045",
            "fax_number": "601-249-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ERIC",
        "middle_name": "STREET",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MS",
            "license": "2494-89",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660038",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Ray Lea, B.S.
• Benjamin Lee
• Natasha Collins Lee
• Magan Legg
• Rex Anne Leggett, RN
• Jessica Lewis, BS
• Terrilyn Lewis, NP-C, MSN
• Life Apps for Families, LLC
• Life-Time Hospice LLC
• Betsy Wicker Lindsey, PHARMACIST

• Oral and Maxillofacial Surgery (Dentist) in McComb, MS
• Providers in McComb, MS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.