Active NPI
Daniel Ethan Lapidus, D.D.S
- Dentist
- San Luis Obispo, CA
National Provider Identifier
1811042138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57039
- Practice address
- 1551 Bishop St Ste 420
San Luis Obispo, CA 93401-4663 - Phone
- (805) 543-7993
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7075 | AZ | |
| Dentist | 122300000X | 57039 | CA | Primary |
Addresses
Primary practice location
1551 Bishop St Ste 420
San Luis Obispo, CA 93401-4663
Mailing address
3933 Carissa CT
San Luis Obispo, CA 93401-7417
Phone (805) 540-0425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150710000032 | CA | Order and Referring Only - Other (Non-Physician) | 4486966041 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7075 | AZ | MD | Dentist |
| 57039 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1811042138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3933 CARISSA CT",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934017417",
"telephone_number": "805-540-0425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1551 BISHOP ST STE 420",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014663",
"telephone_number": "805-543-7993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAPIDUS",
"first_name": "DANIEL",
"middle_name": "ETHAN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "7075",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.