Ethan Lim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00206620 Issued in CO

Practice address

2535 S Lewis Way Ste 105
Lakewood, CO 80227-6558

Phone

(303) 936-5644

NPI assigned

May 6, 2025

Sex

Male

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 OH

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 and National Provider Directory roles.

• Lakewood PDC PLLC

  • General Practice Dentistry
  • Lakewood, CO
  • NPI 1811855059
  NPD (past)

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1386433118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 S LEWIS WAY STE 105",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802276558",
            "telephone_number": "330-489-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 S LEWIS WAY STE 105",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802276558",
            "telephone_number": "303-936-5644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6525 W 44th Ave",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "800334735",
            "country_code": "US",
            "telephone_number": "303-421-8753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-06",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00206620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie K Lillie Sr., MSW LCSW
• Jennifer Lillie, LPCC, ATR-P
• Barbara Y Lillo, CCA
• Nicole Marie Lilly, AU.D
• Annie Kyoung Lim, D.O.
• Vinicius Jorge Lima, D.M.D
• Keena A Limer, CPFS
• Limitless Concierge Physical Therapy LLC
• Bogdan Limpede, DDS
• Cindy Lin

• General Practice Dentistry in Lakewood, CO
• Providers in Lakewood, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.