Individual provider Active NPI

Aeni Lim, DDS

  • General Practice Dentistry
  • Mansfield, TX
National Provider Identifier
1023452166
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28698 Issued in TX
Practice address
1551 Highway 287 N
Suite 411
Mansfield, TX 76063-8890
Phone
(817) 453-6108
NPI assigned
Apr 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28698 TX Primary

Addresses

Primary practice location

1551 Highway 287 N
Suite 411
Mansfield, TX 76063-8890

Mailing address

701 E Bluff St
Apt 2108
Fort Worth, TX 76102-2300
Phone (817) 453-6108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20161006002415 WA Order and Referring Only - DentistPractitioner - Dentist 9931497963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28698TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brus & Lim, PPLC General Practice CurrentSince Jan 19, 2020 Accepting new patients
Debbie Lane Dental & Orthodontics, PLLC General Practice Past Accepting new patients

Locations

16021 Meridian E
Puyallup, WA 98375
Phone (253) 845-1600

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1023452166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E BLUFF ST",
            "address_2": "APT 2108",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761022300",
            "telephone_number": "817-453-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 HIGHWAY 287 N",
            "address_2": "SUITE 411",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638890",
            "telephone_number": "817-453-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "AENI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.