Individual provider Active NPI

Kenny Dao Lam, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Chandler, AZ
National Provider Identifier
1487717187
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D7529 Issued in AZ
Practice address
4410 S Rio Dr
Chandler, AZ 85249-3382
Phone
(480) 786-0557
NPI assigned
Dec 18, 2006
Last updated
Oct 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 051761 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D7529 AZ Primary

Addresses

Primary practice location

4410 S Rio Dr
Chandler, AZ 85249-3382

Mailing address

4410 S Rio Dr
Chandler, AZ 85249-3382
Phone (480) 786-0557

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7529AZMDOral and Maxillofacial Surgery (Dentist)
051761NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1487717187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 S RIO DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493382",
            "telephone_number": "480-786-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 S RIO DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852493382",
            "telephone_number": "480-786-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "KENNY",
        "middle_name": "DAO",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051761",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D7529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.