Individual provider Active NPI

Raphael C Lewis, D.D.S

  • General Practice Dentistry
  • Beverly Hills, FL
National Provider Identifier
1932295706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14507 Issued in CA
Practice address
1 Regina Blvd
Beverly Hills, FL 34465-4086
Phone
(352) 746-0330
Fax
(352) 746-2846
NPI assigned
Oct 5, 2006
Sex
Male
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 DN14507 CA Primary

Addresses

Primary practice location

1 Regina Blvd
Beverly Hills, FL 34465-4086

Mailing address

1 Regina Blvd
Beverly Hills, FL 34465-4086
Phone (352) 746-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160412001284 FL Order and Referring Only - DentistPractitioner - Dentist 9830497650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN14507CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932295706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 REGINA BLVD",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654086",
            "telephone_number": "352-746-0330",
            "fax_number": "352-746-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 REGINA BLVD",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654086",
            "telephone_number": "352-746-0330",
            "fax_number": "352-746-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "RAPHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DN14507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, FL

Sources for this page

Verify at the official NPI Registry.