Individual provider Active NPI

Andy Dao Lam, D.D.S.

  • General Practice Dentistry
  • Garland, TX
National Provider Identifier
1164440509
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25921 Issued in TX
Practice address
1309 Northwest Highway
Garland, TX 75041-5837
Phone
(972) 926-4800
Fax
(972) 926-4880
NPI assigned
Jul 17, 2006
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 25921 TX
General Practice Dentistry 1223G0001X 25921 TX Primary

Addresses

Primary practice location

1309 Northwest Highway
Garland, TX 75041-5837

Mailing address

1309 Northwest Highway
Garland, TX 75041-5837
Phone (972) 926-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151102002764 TX Order and Referring Only - DentistPractitioner - Dentist 1658681705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25921TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Andy Dao Lam DDS Inc General Practice PastSince Jun 22, 2021 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, 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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1164440509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 NORTHWEST HIGHWAY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415837",
            "telephone_number": "972-926-4800",
            "fax_number": "972-926-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 NORTHWEST HIGHWAY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415837",
            "telephone_number": "972-926-4800",
            "fax_number": "972-926-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "ANDY",
        "middle_name": "DAO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.