Individual provider Active NPI

Carmen Lam, D.D.S.

  • Dentist
  • New York, NY
National Provider Identifier
1275068249
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
059850 Issued in NY
Practice address
120 Central Park S Ste 1a
New York, NY 10019-1508
Phone
(347) 325-2665
NPI assigned
Apr 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 059850 NY Primary

Addresses

Primary practice location

120 Central Park S Ste 1a
New York, NY 10019-1508

Mailing address

120 Central Park S Ste 1a
New York, NY 10019-1508
Phone (347) 325-2665

Other practice location 1

4422 3rd Ave
Dental Dept
Bronx, NY 10457-2545
Phone (718) 960-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221213000344 NY Practitioner - Dentist 3476897497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Nov 1, 2022 Accepting new patients

Locations

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1275068249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CENTRAL PARK S STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191508",
            "telephone_number": "347-325-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CENTRAL PARK S STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191508",
            "telephone_number": "347-325-2665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 3rd Ave",
            "address_2": "Dental Dept",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104572545",
            "country_code": "US",
            "telephone_number": "718-960-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "CARMEN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.