Individual provider Active NPI

Adriane Louise Lippian, DDS

  • General Practice Dentistry
  • Texarkana, TX
National Provider Identifier
1912060849
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22928 Issued in TX
Practice address
204 McCartney Blvd
Texarkana, TX 75503-3018
Phone
(903) 793-6976
Fax
(903) 793-8497
NPI assigned
Dec 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 22928 TX Primary

Addresses

Primary practice location

204 McCartney Blvd
Texarkana, TX 75503-3018

Mailing address

204 McCartney Blvd
Texarkana, TX 75503-3018
Phone (903) 793-6976

Other identifiers 1

IdentifierTypeStateIssuer
63NQOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150724012382 TX Order and Referring Only - DentistPractitioner - Dentist 5496068058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22928TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lippian Family Dentistry, P.C. General Practice PastSince Jul 3, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912060849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MCCARTNEY BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033018",
            "telephone_number": "903-793-6976",
            "fax_number": "903-793-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MCCARTNEY BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033018",
            "telephone_number": "903-793-6976",
            "fax_number": "903-793-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPIAN",
        "first_name": "ADRIANE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "63NQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.