MEDICARE: DR. LISSETTE AIXA SILVA OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0003785	CO

General Provider Information

NPI Number	:	1669101556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISSETTE AIXA SILVA OD

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	6460 E YALE AVE UNIT A20
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-7145
Country	:	US
Telephone Number	:	720-316-7739
Fax Number	:	720-259-9360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	12/08/2025

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