Individual provider Active NPI

Semi Lim, D.M.D

  • Periodontics
  • Walnut Creek, CA
National Provider Identifier
1275652943
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
56555 Issued in CA
Practice address
1575 Treat Blvd
Suite 115
Walnut Creek, CA 94598-1048
Phone
(925) 939-9177
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DS035958 PA
Periodontics 1223P0300X 56555 CA Primary

Addresses

Primary practice location

1575 Treat Blvd
Suite 115
Walnut Creek, CA 94598-1048

Mailing address

1000 National Ave.
#201
San Bruno, CA 94066

Other names 1

  • Dr. Semi Lee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS035958PAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1275652943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NATIONAL AVE.",
            "address_2": "#201",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "94066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 TREAT BLVD",
            "address_2": "SUITE 115",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945981048",
            "telephone_number": "925-939-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "SEMI",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS035958",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "56555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEMI",
            "last_name": "LEE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.