Active NPI
Denise Robin Lyons, D.D.S
- General Practice Dentistry
- Goodfellow Afb, TX
National Provider Identifier
1679649750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 051259-1
- Practice address
- Dept of the Air Force
17TH Dental Flight (Aetc)
Goodfellow Afb, TX 76908 - Phone
- (325) 654-3050
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 051259-1 | NY | Primary |
Addresses
Primary practice location
Dept of the Air Force
17TH Dental Flight (Aetc)
Goodfellow Afb, TX 76908
Mailing address
4022 Green Meadow Dr. Apt 503
San Angelo, TX 76904
Phone (315) 591-8811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 20, 2015 through Oct 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051259-1 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679649750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4022 GREEN MEADOW DR. APT 503",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "76904",
"telephone_number": "315-591-8811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DEPT OF THE AIR FORCE",
"address_2": "17TH DENTAL FLIGHT (AETC)",
"city": "GOODFELLOW AFB",
"state": "TX",
"postal_code": "76908",
"telephone_number": "325-654-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "DENISE",
"middle_name": "ROBIN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "051259-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodfellow Afb, TX
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; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.