Ella Tin Aye Khine Lim, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

62040 Issued in CA

Practice address

29 Rotary Way
Vallejo, CA 94591-8475

Phone

(707) 554-1764

NPI assigned

Jul 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Capital Family Dental Group

  • Dentist
  • Sacramento, CA
  • NPI 1154872406
  NPD (past)
• Stevenson and Cohen, a Professional Corporation

  • Endodontics
  • Vallejo, CA
  • NPI 1053697128
  NPD (past)

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

{
    "created_epoch": "1311465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1518245604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 DEBBI CT",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945536609",
            "telephone_number": "858-200-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 ROTARY WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918475",
            "telephone_number": "707-554-1764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 L St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958165248",
            "country_code": "US",
            "telephone_number": "916-452-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "ELLA",
        "middle_name": "TIN AYE KHINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-24",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038804",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylee Liddle
• Nicole Lightburn
• Esker-D Ligon, RN, NP
• Benjamin Pulido Ligot, M.D.
• Cynthia Lim, MD
• Jacquie Lim, DDS
• Larry Lim, DDS
• Ryan Lim, RRT
• Steve Lim, MD
• Vincent Patrick Lim, DDS

• Dentist in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.