Individual provider Active NPI

Pin-Chuang Lai, DDS

  • Periodontics
  • Kansas City, MO
National Provider Identifier
1417290701
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2022006623 Issued in MO
Practice address
650 E 25TH St
Kansas City, MO 64108-2716
Phone
(816) 235-2127
NPI assigned
Apr 4, 2013
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X RES.3166 OH
Periodontics 1223P0300X 2022006623 MO Primary

Addresses

Primary practice location

650 E 25TH St
Kansas City, MO 64108-2716

Mailing address

650 E 25TH St
Kansas City, MO 64108-2716
Phone (816) 235-2127

Other practice location 1

305 W 12th Ave Rm 2015
Columbus, OH 43210-1267
Phone (614) 292-4927

Other identifiers 1

IdentifierTypeStateIssuer
2022006623OtherMOMISSOURI DENTAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20160222002666 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587969035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022006623MOMDPeriodontist
RES.3166OHMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1417290701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 12th Ave Rm 2015",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-292-4927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAI",
        "first_name": "PIN-CHUANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "RES.3166",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2022006623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI DENTAL BOARD",
            "identifier": "2022006623",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.