Alice Lim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011941 Issued in AZ

Practice address

3440 E Baseline Rd Ste 106
Mesa, AZ 85204-7247

Phone

(480) 926-2350

NPI assigned

Apr 11, 2022

Last updated

Aug 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mesa Modern Dentistry, LLP

  dba Mesa Modern Dentistry

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1477821460
  NPD (past)

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1265174239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11256 E CONTESSA ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852071708",
            "telephone_number": "707-732-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 E BASELINE RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047247",
            "telephone_number": "480-926-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lighthouse Support Services LLC
• Lighthouse Support Services LLC
• Daisy Hannah Liljenquist, PA
• Loren Edgar Lilly, RRT
• Christine Lillywhite, M.S., MT-BC
• Kellie Marie Lim, PA-C
• Ruth T. Lim, M.D.
• Tracy Thao Thach Lin, PHARMD
• Erinn Lind
• Philip Lindblom

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.