Individual provider Active NPI

Lisa Sarasqueta, D.D.S.

  • General Practice Dentistry
  • Patterson, CA
National Provider Identifier
1871613638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35165 Issued in CA
Practice address
335 W Las Palmas Ave
Patterson, CA 95363-2519
Phone
(209) 892-6702
Fax
(209) 892-2220
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 35165 CA Primary

Addresses

Primary practice location

335 W Las Palmas Ave
Patterson, CA 95363-2519

Mailing address

PO Box 596
Patterson, CA 95363-0596
Phone (209) 892-6702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20151222000827 CA Order and Referring Only - DentistPractitioner - Dentist 7911208640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871613638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953630596",
            "telephone_number": "209-892-6702",
            "fax_number": "209-892-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 W LAS PALMAS AVE",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953632519",
            "telephone_number": "209-892-6702",
            "fax_number": "209-892-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARASQUETA",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patterson, CA

Sources for this page

Verify at the official NPI Registry.