Individual provider Active NPI

Tammy Ly, DDS

  • General Practice Dentistry
  • Sulphur, LA
National Provider Identifier
1104551779
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7362 Issued in LA
Practice address
2920 Maplewood Dr
Sulphur, LA 70663-6114
Phone
(337) 625-2671
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7362 LA Primary
General Practice Dentistry 1223G0001X 38787 TX

Addresses

Primary practice location

2920 Maplewood Dr
Sulphur, LA 70663-6114

Mailing address

5225 Elliott Rd Apt 1115
Lake Charles, LA 70605-5806

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
38787TXMDClinical Psychologist
7362LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Parkway Dental PLLC General Practice CurrentSince Jun 18, 2023 Accepting new patients
Sulphur Dental Associates General Practice Past Accepting new patients

Locations

2004 S Mason Rd
Ste B3
Katy, TX 77450
Phone (832) 222-0016

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1104551779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 ELLIOTT RD APT 1115",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MAPLEWOOD DR",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706636114",
            "telephone_number": "337-625-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "TAMMY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7362",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.