Active NPI
Jessica Lam
- General Practice Dentistry
- New York, NY
National Provider Identifier
1669094827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 062258
- Practice address
- 198 Canal St Ste 402
New York, NY 10013-4533 - Phone
- (212) 766-2128
- NPI assigned
- May 11, 2020
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 062258 | NY | Primary |
Addresses
Primary practice location
198 Canal St Ste 402
New York, NY 10013-4533
Mailing address
198 Canal St Ste 402
New York, NY 10013-4533
Phone (212) 766-2128
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 |
|---|---|---|---|
| 062258 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1669094827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 CANAL ST STE 402",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134533",
"telephone_number": "212-766-2128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 CANAL ST STE 402",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134533",
"telephone_number": "212-766-2128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-11",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "062258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.