Active NPI
Deja Leticia Gomez-Lewis
- Dental Assistant
- Fort Irwin, CA
National Provider Identifier
1841813292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 4TH and Inner Loop Road
BLDG 171
Fort Irwin, CA 92310 - Phone
- (719) 526-5537
- NPI assigned
- May 20, 2020
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
4TH and Inner Loop Road
BLDG 171
Fort Irwin, CA 92310
Mailing address
4TH and Inner Loop Road
BLDG 171
Fort Irwin, CA 92310
Phone (719) 526-5537
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589932800000",
"number": "1841813292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4TH AND INNER LOOP ROAD",
"address_2": "BLDG 171",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "719-526-5537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4TH AND INNER LOOP ROAD",
"address_2": "BLDG 171",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "719-526-5537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ-LEWIS",
"first_name": "DEJA",
"middle_name": "LETICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-20",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.