Individual provider Active NPI

Shirley Livingston, D.D.S.

  • Dentist
  • Berkeley, CA
National Provider Identifier
1598821779
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51654 Issued in CA
Practice address
1860 Alcatraz Avenue
Berkeley, CA 94703
Phone
(510) 653-8500
NPI assigned
Dec 29, 2006
Last updated
Jan 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 51654 CA Primary

Addresses

Primary practice location

1860 Alcatraz Avenue
Berkeley, CA 94703

Mailing address

1860 Alcatraz Ave
Berkeley, CA 94703-2715

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
I20110622000212 CA Order and Referring Only - DentistPractitioner - Dentist 8729266739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care Past Accepting new patients
Lifelong Medical Care Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1598821779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 ALCATRAZ AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 ALCATRAZ AVENUE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94703",
            "telephone_number": "510-653-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "SHIRLEY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.