Lorraine Josephine Celis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009908A Issued in IN

Practice address

2628 E Jefferson Blvd
South Bend, IN 46615-2724

Phone

(574) 233-7266

Fax

(574) 233-7560

NPI assigned

Feb 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jefferson Dental Center, Inc.

  • Dental Clinic/Center
  • South Bend, IN
  • NPI 1760762108
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186099200000",
    "number": "1841334125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152724",
            "telephone_number": "574-233-7266",
            "fax_number": "574-233-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152724",
            "telephone_number": "574-233-7266",
            "fax_number": "574-233-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELIS",
        "first_name": "LORRAINE",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009908A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Cavadini, DO
• Connor Cavanaugh, MD
• John J Cavanaugh, MD
• Christina Marie Cavinder, CPNP-PC
• CBS Transpro, Inc.
• Joseph Vincent Cellini, DMD
• Center for Eye-Care Excellence
• Center for Hospice and Palliative Care, Inc
• Center for Positive Change, Inc
• Center for Positive Change, Inc

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2007; 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.

Verify at the official NPI Registry.