Matthew Ross Lisenby, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7249 Issued in NV

Practice address

1457 S Carson St Ste 101
Carson City, NV 89701-5240

Phone

(775) 372-9898

NPI assigned

Jul 6, 2019

Sex

Male

Sole proprietor

Yes

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 TX

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

Practice roles

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.

• Matthew Lisenby DMD PC

  • General Practice Dentistry
  • Reno, NV
  • NPI 1003763905
  NPD Authorized official
• Boehme Dentists of Carson City, PC

  • Dentist
  • Carson City, NV
  • NPI 1265955009
  NPD (past)
• Quinn Stephanie Dental Group, Professional Corporation

  • General Practice Dentistry
  • Henderson, NV
  • NPI 1376726885
  NPD (past)

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

{
    "created_epoch": "1562371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1992367338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 EVERGREEN CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 S CARSON ST STE 101",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897015240",
            "telephone_number": "775-372-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENBY",
        "first_name": "MATTHEW",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-06",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NV",
            "license": "7249",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincare Inc
• Brandie Natasha Lincoln
• Christopher N. Lingard, DMD
• Dylan Linnell, PA-C
• Tanya Liscio, APRN
• Litedpath, LLC
• Nalyssa Kirsten Little, DO
• Edith Littrell
• Maria Livingston
• Carole Logan

• General Practice Dentistry in Carson City, NV
• Providers in Carson City, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.