Individual provider Active NPI

Lily T Garcia, DDS MS

  • Prosthodontics
  • Las Vegas, NV
National Provider Identifier
1619088853
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
S5-54C Issued in NV
Practice address
1001 Shadow LN # Ms 7410
Las Vegas, NV 89106-4124
Phone
(702) 774-2500
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 14182 TX
Prosthodontics 1223P0700X 40149 IA
Prosthodontics 1223P0700X 6853 CO
Prosthodontics 1223P0700X S5-54C NV Primary

Addresses

Primary practice location

1001 Shadow LN # Ms 7410
Las Vegas, NV 89106-4124

Mailing address

1001 Shadow LN # Ms 7410
Las Vegas, NV 89106-4124
Phone (702) 774-2500

Other practice location 1

414 Dental Science Bldg S
Iowa CIty, IA 52242-1001
Phone (319) 335-7275

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6853COMDProsthodontist
40149IAMDProsthodontist
S5-54CNVMDProsthodontist
14182TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Past Accepting new patients
Board of Regents, Nevada System of Higher Education PastSince Sep 1, 2019 Accepting new patients
The University of Texas Health Science Center at San Antonio Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1619088853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN # MS 7410",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124",
            "telephone_number": "702-774-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN # MS 7410",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124",
            "telephone_number": "702-774-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Dental Science Bldg S",
            "address_purpose": "LOCATION",
            "city": "Iowa CIty",
            "state": "IA",
            "postal_code": "522421001",
            "country_code": "US",
            "telephone_number": "319-335-7275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "LILY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "14182",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IA",
            "license": "40149",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CO",
            "license": "6853",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NV",
            "license": "S5-54C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.