Lilia Katherine Portales, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

108206 Issued in CA

Practice address

2987 Coronado Ave Ste a
San Diego, CA 92154-2180

Phone

(619) 789-5029

NPI assigned

Oct 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1699492561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 QUIET GRV",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180847",
            "telephone_number": "859-455-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2987 CORONADO AVE STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921542180",
            "telephone_number": "619-789-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTALES",
        "first_name": "LILIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda Pornel, RN
• Elena Porras
• Vanessa Maria Porras
• Porta Verum
• Krystal Rosebud Portalatin, B.A.
• Debra Denise Portee
• Lucilia Goncalves Portela, PT, DPT
• Annalisa Porter, PHARM.D.
• Charmanay Porter
• Deanna Porter

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.