Tracey-Phuong To Lai, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

21400 Issued in MA

Practice address

288 Common St
Watertown, MA 02472-4940

Phone

(626) 759-2770

NPI assigned

May 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1225204795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 COMMON ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724940",
            "telephone_number": "626-759-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 COMMON ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724940",
            "telephone_number": "626-759-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "TRACEY-PHUONG",
        "middle_name": "TO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56463",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Takayuki Kuwahara, LIC. AC.
• Steven Lacey
• Jean K. Ladas, MT
• Charlene Laferrera, TVI
• Alexandra Lahey, FNP-BC
• Dimitri Lamisere, AGPCNP-BC
• April Lamrock
• Luciana Lancellotta
• Gordon Alan Lang, MSW
• Natalie Lang, LICSW

• Dentist in Watertown, MA
• Providers in Watertown, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.