Active NPI
Richard S. Lim, DDS, Inc.
- Dentist
- Yucaipa, CA
National Provider Identifier
1497146872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62480
- Legal business name
- RICHARD S. LIM, DDS, INC.
- Practice address
- 11834 Bryant St Ste 102
Yucaipa, CA 92399-3848 - Phone
- (909) 797-8090
- Fax
- (909) 918-0595
- NPI assigned
- Feb 6, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Richard S. Lim, DDS
- Title
- Owner Ceo
- Phone
- (909) 797-8090
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62480 | CA | Primary |
Addresses
Primary practice location
11834 Bryant St Ste 102
Yucaipa, CA 92399-3848
Mailing address
11834 Bryant St Ste 102
Yucaipa, CA 92399-3848
Phone (909) 797-8090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962842575 | Medicaid | CA |
Other names 1
- Yucaipa Family Dental
National Provider Directory
National Provider DirectoryLocations
11834 Bryant St
Ste 102
Yucaipa, CA 92399
Phone (909) 797-8090
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Yucaipa, CA
- NPI 1962842575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423180800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560211200000",
"number": "1497146872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11834 BRYANT ST STE 102",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923993848",
"telephone_number": "909-797-8090",
"fax_number": "909-918-0595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11834 BRYANT ST STE 102",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923993848",
"telephone_number": "909-797-8090",
"fax_number": "909-918-0595"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RICHARD S. LIM, DDS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-06",
"last_updated": "2019-06-11",
"status": "A",
"authorized_official_last_name": "LIM",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "OWNER CEO",
"authorized_official_telephone_number": "909-797-8090",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "CA",
"license": "62480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1962842575",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Yucaipa Family Dental",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Yucaipa Family Dental",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Yucaipa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.