Individual provider Active NPI

Igor Lantsberg, DDS

  • Dentist
  • San Diego, CA
National Provider Identifier
1730678798
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104141 Issued in CA
Practice address
2840 5TH Ave Ste 300
San Diego, CA 92103-6307
Phone
(619) 291-4325
NPI assigned
May 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 104141 CA Primary

Addresses

Primary practice location

2840 5TH Ave Ste 300
San Diego, CA 92103-6307

Mailing address

1670 Guy St Apt E
San Diego, CA 92103-3763
Phone (347) 613-5082

Other practice location 1

11738 Carmel Mountain Rd
San Diego, CA 92128-4634
Phone (858) 675-1180

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104141CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Art of Dentistry Dentist PastSince Feb 6, 2022 Accepting new patients

Organizations & group practices 1

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": "1525478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1730678798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 GUY ST APT E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033763",
            "telephone_number": "347-613-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 5TH AVE STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036307",
            "telephone_number": "619-291-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11738 Carmel Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921284634",
            "country_code": "US",
            "telephone_number": "858-675-1180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANTSBERG",
        "first_name": "IGOR",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-05",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "104141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.