Individual provider Active NPI

Evan Elizabeth Lemley, DDS

  • Dentist
  • Loma Linda, CA
National Provider Identifier
1962608349
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55411 Issued in CA
Practice address
VA Loma Linda Health Care System # 160
11201 Benton St
Loma Linda, CA 92357-0001
Phone
(909) 583-6127
NPI assigned
Jun 22, 2007
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
Dentist 122300000X 55411 CA Primary

Addresses

Primary practice location

VA Loma Linda Health Care System # 160
11201 Benton St
Loma Linda, CA 92357-0001

Mailing address

25590 Prospect Ave
46F
Loma Linda, CA 92354-3141
Phone (909) 769-2236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962608349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25590 PROSPECT AVE",
            "address_2": "46F",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543141",
            "telephone_number": "909-769-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA LOMA LINDA HEALTH CARE SYSTEM # 160",
            "address_2": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923570001",
            "telephone_number": "909-583-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMLEY",
        "first_name": "EVAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.