Individual provider Active NPI

Lewis L Specker, D.D.S.

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1467455980
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D23565 Issued in CA
Practice address
180 Montgomery St
San Francisco, CA 94104-4205
Phone
(415) 982-7443
Fax
(415) 362-1321
NPI assigned
May 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D23565 CA Primary

Addresses

Primary practice location

180 Montgomery St
San Francisco, CA 94104-4205

Mailing address

180 Montgomery St
San Francisco, CA 94104-4205
Phone (415) 982-7443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150723009313 CA Order and Referring Only - DentistPractitioner - Dentist 9436462108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D23565CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467455980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 MONTGOMERY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044205",
            "telephone_number": "415-982-7443",
            "fax_number": "415-362-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MONTGOMERY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044205",
            "telephone_number": "415-982-7443",
            "fax_number": "415-362-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECKER",
        "first_name": "LEWIS L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D23565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.