NPIMap

Organization Active NPI

Larry Lim D.D.S Inc.

  • General Practice Dentistry
  • Vallejo, CA
National Provider Identifier
1417164104
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43362 Issued in CA
Legal business name
LARRY LIM D.D.S INC.
Practice address
140 Robles Way
Vallejo, CA 94591-8039
Phone
(707) 645-8400
Fax
(707) 645-8459
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jaymie Santiago
Title
Office Manager
Phone
(707) 645-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 43362 CA Primary

Addresses

Primary practice location

140 Robles Way
Vallejo, CA 94591-8039

Mailing address

140 Robles Way
Vallejo, CA 94591-8039
Phone (707) 645-8400

National Provider Directory

National Provider Directory

Locations

140 Robles Way
Vallejo, CA 94591
Phone (707) 645-8400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417164104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROBLES WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918039",
            "telephone_number": "707-645-8400",
            "fax_number": "707-645-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ROBLES WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918039",
            "telephone_number": "707-645-8400",
            "fax_number": "707-645-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY LIM D.D.S INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "JAYMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "707-645-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.