Active NPI
Victoria Lee Lo, DDS
- Endodontics
- Fremont, CA
National Provider Identifier
1558970426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 106806
- Practice address
- 39835 Paseo Padre Pkwy
Fremont, CA 94538-2974 - Phone
- (510) 683-8900
- NPI assigned
- Jul 27, 2020
- Last updated
- Jul 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 106806 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
39835 Paseo Padre Pkwy
Fremont, CA 94538-2974
Mailing address
19530 Via Monte Dr
Saratoga, CA 95070-4522
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
| License | State | Type | Specialty |
|---|---|---|---|
| 106806 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1558970426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19530 VIA MONTE DR",
"city": "SARATOGA",
"state": "CA",
"postal_code": "950704522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39835 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382974",
"telephone_number": "510-683-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "VICTORIA",
"middle_name": "LEE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "106806",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.