Dragonfly Senior Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DRAGONFLY SENIOR LIVING, INC.

Practice address

17 Louie Ave
Lodi, CA 95240-1283

Phone

(209) 369-8282

NPI assigned

Oct 25, 2024

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Secretary

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1831911478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LOUIE AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952401283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LOUIE AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952401283",
            "telephone_number": "209-369-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAGONFLY SENIOR LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica Duncan, DPT
• Lily Duong, PHARMD

• Assisted Living Facility in Lodi, CA
• Providers in Lodi, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.