Lisa Irish Deese, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009122 Issued in AZ

Practice address

1100 F Ave
Douglas, AZ 85607-1919

Phone

(520) 364-3285

Fax

(520) 364-3378

NPI assigned

May 18, 2010

Last updated

May 1, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisa.deese.p1@direct.cchci.nextgenshare.com

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.

• Chiricahua Community Health Centers, Inc

  dba Business Office

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1942241443
  NPD (past)
• Chiricahua Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sierra Vista, AZ
  • NPI 1629499397
  NPD (past)

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1639498595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071919",
            "telephone_number": "520-364-3285",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071919",
            "telephone_number": "520-364-3285",
            "fax_number": "520-364-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEESE",
        "first_name": "LISA",
        "middle_name": "IRISH",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009122",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192919",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Douglas, AZ
• Providers in Douglas, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.