Individual provider Active NPI

Kent Lau, DDS

  • Dentist
  • Claremont, CA
National Provider Identifier
1205242906
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63511 Issued in CA
Practice address
405 W Foothill Blvd Ste 104
Claremont, CA 91711-2786
Phone
(909) 626-1236
NPI assigned
Jul 2, 2014
Last updated
May 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63511 CA Primary

Addresses

Primary practice location

405 W Foothill Blvd Ste 104
Claremont, CA 91711-2786

Mailing address

405 W Foothill Blvd Ste 104
Claremont, CA 91711-2786
Phone (909) 626-1236

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
I20150813010581 CA Order and Referring Only - DentistPractitioner - Dentist 4385959741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63511CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee and Sambangi Dental Corporation Past 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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1205242906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W FOOTHILL BLVD STE 104",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112786",
            "telephone_number": "909-626-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W FOOTHILL BLVD STE 104",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112786",
            "telephone_number": "909-626-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "KENT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

Verify at the official NPI Registry.