Individual provider Active NPI

Binh Bao Lam, D.D.S.

  • Dentist
  • San Jose, CA
National Provider Identifier
1679889869
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59595 Issued in CA
Practice address
3869 Thompson Creek CT
San Jose, CA 95135-1000
Phone
(415) 683-1008
NPI assigned
Aug 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59595 CA Primary

Addresses

Primary practice location

3869 Thompson Creek CT
San Jose, CA 95135-1000

Mailing address

345 Estudillo Ave
Ste 102
San Leandro, CA 94577-4702
Phone (415) 683-1008

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412002535 CA Order and Referring Only - Other (Non-Physician) 4082912738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1679889869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 ESTUDILLO AVE",
            "address_2": "STE 102",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774702",
            "telephone_number": "415-683-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3869 THOMPSON CREEK CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351000",
            "telephone_number": "415-683-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "BINH",
        "middle_name": "BAO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.