Individual provider Active NPI

Victoria Lai

  • Dentist
  • San Jose, CA
National Provider Identifier
1083116214
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS104178 Issued in CA
Practice address
55 E Julian St
San Jose, CA 95112-4007
Phone
(408) 457-7100
NPI assigned
Mar 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DDS104178 CA Primary

Addresses

Primary practice location

55 E Julian St
San Jose, CA 95112-4007

Mailing address

55 E Julian St
San Jose, CA 95112-4007
Phone (408) 457-7100

Other practice location 1

164 Kinman Ave
Santa Barbara, CA 93117-3481
Phone (805) 617-7900

Other practice location 2

923 N Milpas St
Santa Barbara, CA 93103-2331
Phone (805) 884-1998

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

LicenseStateTypeSpecialty
DDS104178CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara Neighborhood Clinics Past Accepting new patients
Santa Barbara Neighborhood Clinics 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": "1520121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1083116214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E JULIAN ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124007",
            "telephone_number": "408-457-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E JULIAN ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124007",
            "telephone_number": "408-457-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Kinman Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931173481",
            "country_code": "US",
            "telephone_number": "805-617-7900",
            "fax_number": "805-617-7899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "923 N Milpas St",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931032331",
            "country_code": "US",
            "telephone_number": "805-884-1998",
            "fax_number": "805-884-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAI",
        "first_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-04",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.