Individual provider Active NPI

Karen Lam Kishiyama, DDS, MS

  • Pediatric Dentistry
  • San Mateo, CA
National Provider Identifier
1407110190
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
61957 Issued in CA
Practice address
177 Bovet Rd Ste 180
San Mateo, CA 94402-3117
Phone
(650) 372-9292
NPI assigned
Jun 27, 2012
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 61957 CA Primary

Addresses

Primary practice location

177 Bovet Rd Ste 180
San Mateo, CA 94402-3117

Mailing address

177 Bovet Rd Ste 180
San Mateo, CA 94402-3117
Phone (650) 372-9292

Other names 1

  • Dr. Karen Lam Professional 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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1407110190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 BOVET RD STE 180",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023117",
            "telephone_number": "650-372-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 BOVET RD STE 180",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023117",
            "telephone_number": "650-372-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHIYAMA",
        "first_name": "KAREN",
        "middle_name": "LAM",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "61957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "LAM",
            "prefix": "DR.",
            "credential": "DDS, MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.