Individual provider Active NPI

Brent Carl Lay, DDS

  • General Practice Dentistry
  • Los Gatos, CA
National Provider Identifier
1386773166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34142 Issued in CA
Practice address
24900 Highland Way
Los Gatos, CA 95033-8002
Phone
(408) 353-1191
Fax
(408) 353-6501
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34142 CA Primary

Addresses

Primary practice location

24900 Highland Way
Los Gatos, CA 95033-8002

Mailing address

24900 Highland Way
Los Gatos, CA 95033-8002
Phone (408) 353-1191

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161205001208 CA Order and Referring Only - DentistPractitioner - Dentist 8527348705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386773166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24900 HIGHLAND WAY",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950338002",
            "telephone_number": "408-353-1191",
            "fax_number": "408-353-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24900 HIGHLAND WAY",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950338002",
            "telephone_number": "408-353-1191",
            "fax_number": "408-353-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "BRENT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.