Michelle Ly, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DP0007 Issued in AZ

Practice address

67 N Dobson Rd Ste 104
Mesa, AZ 85201-6824

Phone

(480) 900-7838

Fax

(480) 999-3478

NPI assigned

May 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Happy Molar Dental LLC

  • Dentist
  • Mesa, AZ
  • NPI 1609475060
  NPD Authorized official
• Just Dental

  • Dentist
  • Mesa, AZ
  • NPI 1023862463
  NPD Authorized official
• Just Cleanings, LLC

  • Dentist
  • Mesa, AZ
  • NPI 1144085010
  NPD
• Andrew M Petersen, DDS, LLC

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1114189883

  Single Specialty

  NPD (past)
• Dental Specialty Associates

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1114180320
  NPD (past)

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

{
    "created_epoch": "1590278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1992328058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 N DOBSON RD STE A-104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016822",
            "telephone_number": "480-900-7838",
            "fax_number": "480-999-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 N DOBSON RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016824",
            "telephone_number": "480-900-7838",
            "fax_number": "480-999-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-24",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "DP0007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Luxottica Retail North America Inc
• Jeanne Ly, PHARMD
• Lyl Phoenix LLC
• Kate Lyman
• Whitney Lymer
• Alyssa Patrice Lynch
• Lynn M Knuth, LLC

• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; 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.