Migsal Lhamo Andrugtsang
Individual provider Active NPI Dentist · Carson, CA
NPI 1548011174 · NPPES record last updated Aug 11, 2025
Key facts
- NPI
- 1548011174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 111958 (CA)
- Practice address
- 612 E Carson St Ste 101
Carson, CA 90745-2896 - Phone
- (310) 469-9355
- NPI assigned
- Apr 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111958 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walter Jefferson, D.D.S., Inc. | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 111958 | CA | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | MA |
Addresses
Primary practice location
612 E Carson St Ste 101
Carson, CA 90745-2896
Mailing address
21601 Avalon Blvd Apt 228
Carson, CA 90745-2349
Phone (347) 761-8490
Other practice location 1
1 Kneeland St
Boston, MA 02111-1527
Phone (617) 627-5000
Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.