Individual provider Active NPI

Lily Neskin, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1831797489
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105595 Issued in CA
Practice address
4454 Shorepointe Way
San Diego, CA 92130-8635
Phone
(619) 793-9011
NPI assigned
Oct 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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 105595 CA Primary

Addresses

Primary practice location

4454 Shorepointe Way
San Diego, CA 92130-8635

Mailing address

4454 Shorepointe Way
San Diego, CA 92130-8635
Phone (619) 793-9011

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
105595CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1831797489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 SHOREPOINTE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921308635",
            "telephone_number": "619-793-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4454 SHOREPOINTE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921308635",
            "telephone_number": "619-793-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESKIN",
        "first_name": "LILY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105595",
            "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 15, 2020; 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.