Active NPI
Peter Phong Lai, DDS
- Dentist
- San Francisco, CA
National Provider Identifier
1023263530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55533
- Practice address
- 2243 Van Ness Ave
Suite 101
San Francisco, CA 94109-2504 - Phone
- (415) 441-2098
- NPI assigned
- Nov 25, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 55533 | CA | Primary |
Addresses
Primary practice location
2243 Van Ness Ave
Suite 101
San Francisco, CA 94109-2504
Mailing address
2243 Van Ness Ave
Suite 101
San Francisco, CA 94109-2504
Phone (415) 441-2098
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55533 | Other | CA | CALIFORNIA DENTAL LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55533 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles C. Nip, DDS Inc | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- San Francisco, CA
- NPI 1245625771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227571200000",
"number": "1023263530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2243 VAN NESS AVE",
"address_2": "SUITE 101",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941092504",
"telephone_number": "415-441-2098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2243 VAN NESS AVE",
"address_2": "SUITE 101",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941092504",
"telephone_number": "415-441-2098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAI",
"first_name": "PETER",
"middle_name": "PHONG",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-25",
"last_updated": "2008-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA DENTAL LICENSE",
"identifier": "55533",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.