Active NPI
David Milton Lewis, D.M.D.
- Dentist
- Sacramento, CA
National Provider Identifier
1508069410
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Nov 20, 2017.
- Section 1128b(4) exclusion effective May 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- CA31489
- Practice address
- 4350 Marconi Ave Ste 100
Sacramento, CA 95821-4310 - Phone
- (916) 487-7148
- Fax
- (916) 487-7148
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | CA31489 | CA | Primary |
Addresses
Primary practice location
4350 Marconi Ave Ste 100
Sacramento, CA 95821-4310
Mailing address
4350 Marconi Ave Ste 100
Sacramento, CA 95821-4310
Phone (916) 487-7148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CA31489 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508069410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4350 MARCONI AVE STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958214310",
"telephone_number": "916-487-7148",
"fax_number": "916-487-7148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 MARCONI AVE STE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958214310",
"telephone_number": "916-487-7148",
"fax_number": "916-487-7148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "DAVID",
"middle_name": "MILTON",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "CA31489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.