Individual provider Active NPI

Lisa Marie Lester, DDS

  • General Practice Dentistry
  • Clinton, NY
National Provider Identifier
1922191204
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
047098 Issued in NY
Practice address
46 Utica St
Clinton, NY 13323-1528
Phone
(315) 853-6181
Fax
(315) 859-1038
NPI assigned
Oct 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 047098 NY Primary

Addresses

Primary practice location

46 Utica St
Clinton, NY 13323-1528

Mailing address

46 Utica St
Clinton, NY 13323-1528
Phone (315) 853-6181

Other identifiers 1

IdentifierTypeStateIssuer
02207601MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151221000789 NY Order and Referring Only - DentistPractitioner - Dentist 6103127956

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": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1922191204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 UTICA ST",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231528",
            "telephone_number": "315-853-6181",
            "fax_number": "315-859-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 UTICA ST",
            "city": "CLINTON",
            "state": "NY",
            "postal_code": "133231528",
            "telephone_number": "315-853-6181",
            "fax_number": "315-859-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02207601",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NY

Sources for this page

Verify at the official NPI Registry.