Individual provider Active NPI

Ngocbich Lam Florentino, DDS

  • General Practice Dentistry
  • Elkridge, MD
National Provider Identifier
1649700089
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17610 Issued in MD
Practice address
5877 Deborah Jean Dr
Elkridge, MD 21075-1001
Phone
(719) 229-0913
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 00203190 CO
General Practice Dentistry 1223G0001X 17610 MD Primary

Addresses

Primary practice location

5877 Deborah Jean Dr
Elkridge, MD 21075-1001

Mailing address

5877 Deborah Jean Dr
Elkridge, MD 21075-1001
Phone (719) 229-0913

Other practice location 1

2828 International Cir Ste 100
Colorado Springs, CO 80910-3127
Phone (719) 632-5700

Other practice location 2

2828 International Cir # 100
Colorado Springs, CO 80910-3127

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
00203190COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Better Smiles Family Dental, LLC General Practice Current Accepting new patients
Peak Vista Community Health Centers Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1649700089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5877 DEBORAH JEAN DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210751001",
            "telephone_number": "719-229-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5877 DEBORAH JEAN DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210751001",
            "telephone_number": "719-229-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2828 International Cir Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809103127",
            "country_code": "US",
            "telephone_number": "719-632-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2828 International Cir # 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809103127",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORENTINO",
        "first_name": "NGOCBICH",
        "middle_name": "LAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00203190",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.