Individual provider Active NPI

Dayton Q.L. Lum, D.D.S.

  • General Practice Dentistry
  • Pearl City, HI
National Provider Identifier
1689737504
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1314 Issued in HI
Practice address
850 Kamehameha Highway
Suite 155
Pearl City, HI 96782-2657
Phone
(808) 456-5005
Fax
(808) 454-2569
NPI assigned
Dec 19, 2006
Last updated
Jan 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1314 HI Primary

Addresses

Primary practice location

850 Kamehameha Highway
Suite 155
Pearl City, HI 96782-2657

Mailing address

850 Kamehameha Highway
Suite 155
Pearl City, HI 96782-2657
Phone (808) 456-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20150701001658 HI Order and Referring Only - DentistPractitioner - Dentist 7719299973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1314HIMDPsychologist

Organizations & group practices 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1689737504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 KAMEHAMEHA HIGHWAY",
            "address_2": "SUITE 155",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967822657",
            "telephone_number": "808-456-5005",
            "fax_number": "808-454-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 KAMEHAMEHA HIGHWAY",
            "address_2": "SUITE 155",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967822657",
            "telephone_number": "808-456-5005",
            "fax_number": "808-454-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "DAYTON",
        "middle_name": "Q.L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "1314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl City, HI

Sources for this page

Verify at the official NPI Registry.