Lilly Denture Center, Inc

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000194 Issued in WA

Legal business name

LILLY DENTURE CENTER, INC

Practice address

200 Lilly Rd NE Ste a
Olympia, WA 98506-5080

Phone

(360) 412-0812

Fax

(360) 412-0814

NPI assigned

Dec 4, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Patrick M Carbone, D.P.D.NPI 1740602176

Title

Denturist

Phone

(360) 412-0812

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Carbone

  • Denturist
  • Olympia, WA
  • NPI 1740602176
  NPD (past) Authorized official
• Conor Carbone, DPD

  • Denturist
  • Olympia, WA
  • NPI 1689339889
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851459069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065080",
            "telephone_number": "360-412-0812",
            "fax_number": "360-412-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065080",
            "telephone_number": "360-412-0812",
            "fax_number": "360-412-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLY DENTURE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARBONE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTURIST",
        "authorized_official_telephone_number": "360-412-0812",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.P.D."
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Rachele Liebrecht
• Life Therapeutic Works LLC
• Tamara Light, SUDP
• Kimberlie Lilley Aggerrson
• Lillie McCatty, LMHC (Brides and Boundaries Counseling Services)
• Lilly Road Family Dentistry
• Jennah Rae Lilly
• Kenneth Paul Lim, D.D.S.
• Evan John Lima, PHD
• Lincare Inc.

• Denturist in Olympia, WA
• Providers in Olympia, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.