Individual provider Active NPI

Lisa Strieter, DDS

  • General Practice Dentistry
  • South Bend, IN
National Provider Identifier
1689693806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12899414 Issued in IN
Practice address
1005 E Lasalle Ave
South Bend, IN 46617-2818
Phone
(574) 245-7503
Fax
(574) 245-7502
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12899414 IN Primary

Addresses

Primary practice location

1005 E Lasalle Ave
South Bend, IN 46617-2818

Mailing address

1005 E Lasalle Ave
South Bend, IN 46617-2818
Phone (574) 245-7503

Other identifiers 1

IdentifierTypeStateIssuer
12899414OtherININDIANA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160219002041 IN Order and Referring Only - DentistPractitioner - Dentist 1759503063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12899414INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa M Duncan Strieter DDS LLC CurrentSince Oct 8, 2008 Accepting new patients
The Dental Center of South Bend LLC 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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689693806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172818",
            "telephone_number": "574-245-7503",
            "fax_number": "574-245-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172818",
            "telephone_number": "574-245-7503",
            "fax_number": "574-245-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRIETER",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12899414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "12899414",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.