Individual provider Active NPI

Robert C. Lum, D.M.D.

  • Dentist
  • Sunnyvale, CA
National Provider Identifier
1578706503
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
57989 Issued in CA
Practice address
660 S Fair Oaks Ave
Sunnyvale, CA 94086-7913
Phone
(408) 808-6102
NPI assigned
Apr 6, 2009
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 57989 CA Primary

Addresses

Primary practice location

660 S Fair Oaks Ave
Sunnyvale, CA 94086-7913

Mailing address

660 S Fair Oaks Ave
Sunnyvale, CA 94086-7913

Other practice location 1

2486 W El Camino Real
Mountain View, CA 94040-1421
Phone (408) 808-6102

Other practice location 2

500 Tully Rd
San Jose, CA 95111-1917
Phone (408) 808-6102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221012003235 CA Practitioner - Dentist 8729385661 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57989CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Sep 28, 2022 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Sep 28, 2022 Accepting new patients
County of Santa Clara CurrentSince Sep 28, 2022 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

2486 W El Camino Real
Mountain View, CA 94040
Phone (408) 309-5501

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: rlum186580@santaclaravalley.direct-ci.net

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1578706503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S FAIR OAKS AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940867913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S FAIR OAKS AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940867913",
            "telephone_number": "408-808-6102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2486 W El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940401421",
            "country_code": "US",
            "telephone_number": "408-808-6102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Tully Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951111917",
            "country_code": "US",
            "telephone_number": "408-808-6102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUM",
        "first_name": "ROBERT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-06",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.