Active NPI
Louise C Defelice, DDS
- General Practice Dentistry
- Spokane, WA
National Provider Identifier
1831115526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7719
- Practice address
- 4703 N Maple St
Spokane, WA 99205-5500 - Phone
- (509) 327-7719
- Fax
- (509) 327-7110
- NPI assigned
- Jul 14, 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 | 7719 | WA | Primary |
Addresses
Primary practice location
4703 N Maple St
Spokane, WA 99205-5500
Mailing address
4703 N Maple St
Spokane, WA 99205-5500
Phone (509) 327-7719
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5043781 | Medicaid | WA |
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7719 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1831115526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4703 N MAPLE ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992055500",
"telephone_number": "509-327-7719",
"fax_number": "509-327-7110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4703 N MAPLE ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992055500",
"telephone_number": "509-327-7719",
"fax_number": "509-327-7110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFELICE",
"first_name": "LOUISE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "7719",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5043781",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.