Individual provider Active NPI

Dongbin Nam

  • Dentist
  • Pasadena, CA
National Provider Identifier
1528401981
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49944 Issued in CA
Practice address
257 S de Lacey Ave Unit 2134
Pasadena, CA 91105-4502
Phone
(213) 700-9654
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 49944 CA Primary

Addresses

Primary practice location

257 S de Lacey Ave Unit 2134
Pasadena, CA 91105-4502

Mailing address

257 S de Lacey Ave Unit 2134
Pasadena, CA 91105-4502

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
49944CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1528401981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S DE LACEY AVE UNIT 2134",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911054502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 S DE LACEY AVE UNIT 2134",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911054502",
            "telephone_number": "213-700-9654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "DONGBIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.