Lily E. Cha, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3586 Issued in NM

Practice address

201 San Pedro Dr SE
Suite B-2 (505) 232-5437
Albuquerque, NM 87108-3009

Phone

(505) 232-5437

Fax

(505) 254-7649

NPI assigned

Sep 14, 2011

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1417239666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 8TH ST",
            "address_2": "SUITE 810",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033038",
            "telephone_number": "719-562-4447",
            "fax_number": "719-583-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SAN PEDRO DR SE",
            "address_2": "SUITE B-2 (505) 232-5437",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871083009",
            "telephone_number": "505-232-5437",
            "fax_number": "505-254-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHA",
        "first_name": "LILY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43507573",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Alexander Cervantes
• Cesars Boarding Home
• Andrea Cetera-Jines
• Elisabeth H. Ceysens, RD
• CGC LLC
• Devon S Chabot-Richards, M.D.
• Chacon Individual & Family Therapy, LLC
• Gabriela Chacon Palma, MD
• Amanda Chacon, LSAA
• Briana Chacon, PA-C

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.