Individual provider Active NPI

Derek H Lamb, DMD, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
National Provider Identifier
1063485829
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
43835 Issued in AZ
Practice address
3501 N Scottsdale Rd Ste 226
Scottsdale, AZ 85251-5630
Phone
(480) 941-5005
Fax
(480) 946-0268
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 11990 MN
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 51977 MN
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 43835 AZ Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 07855 AZ

Addresses

Primary practice location

3501 N Scottsdale Rd Ste 226
Scottsdale, AZ 85251-5630

Mailing address

3501 N Scottsdale Rd Ste 226
Scottsdale, AZ 85251-5630
Phone (480) 941-5005

Other identifiers 5

IdentifierTypeStateIssuer
33826700MedicaidWI
832965600MedicaidMN
ENROLLEDMedicaidMN
ENROLLEDMedicaidIA
P00813445OtherMNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150824000607 CA Order and Referring Only - DentistPractitioner - Dentist 6002872298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
07855AZMDOral and Maxillofacial Surgery (Dentist)
43835AZMDOral & Maxillofacial Surgery (D.M.D.)
51977MNMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Facial & Oral Surgery LLC Oral and Maxillofacial Surgery PastSince Jan 19, 2020 Accepting new patients
Derek H. Lamb, DMD, MD, PLLC Oral and Maxillofacial Surgery Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1063485829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 226",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515630",
            "telephone_number": "480-941-5005",
            "fax_number": "480-946-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 226",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515630",
            "telephone_number": "480-941-5005",
            "fax_number": "480-946-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMB",
        "first_name": "DEREK",
        "middle_name": "H",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "11990",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "51977",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "43835",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "07855",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33826700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "832965600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00813445",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.