Active NPI
Erica Tam, DMD
- General Practice Dentistry
- San Jose, CA
National Provider Identifier
1386956266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN1855405
- Practice address
- 2451 S King Rd
Suite C
San Jose, CA 95122-2540 - Phone
- (408) 274-4861
- NPI assigned
- Jul 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1855405 | MA | Primary |
Addresses
Primary practice location
2451 S King Rd
Suite C
San Jose, CA 95122-2540
Mailing address
807 Cedar St
San Carlos, CA 94070-3818
Phone (617) 877-8028
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170824000881 | CA | Order and Referring Only - Dentist | 9537431606 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1855405 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1386956266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 CEDAR ST",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940703818",
"telephone_number": "617-877-8028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2451 S KING RD",
"address_2": "SUITE C",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951222540",
"telephone_number": "408-274-4861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "ERICA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-08",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1855405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.