Elishadie Tezera, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10543 Issued in KY

Practice address

2333 Alexandria Dr
Lexington, KY 40504-3215

Phone

(877) 277-9892

NPI assigned

Jan 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1942891270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1278",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400044278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 ALEXANDRIA DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043215",
            "telephone_number": "877-277-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEZERA",
        "first_name": "ELISHADIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10543",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Price Tesar, NP
• Testing Partners Inc.
• Charles R Teter, APRN
• Shannon Marie Tewes, CRNA
• Jason E Tewmey, PA
• Dirk B Thacker, MD
• Hannah Paige Thacker, PHARMD
• Jeremy Wayne Thacker, M.D.
• Joyce Denise Thacker, APRN-AG
• Pratibha Sahil Thakkar, MD, MPH

• General Practice Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.