Individual provider Active NPI

Stanford C Lai, D.D.S.

  • Dentist
  • San Francisco, CA
National Provider Identifier
1700864774
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36783 Issued in CA
Practice address
5300 Geary Blvd
#210
San Francisco, CA 94121
Phone
(415) 668-8862
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36783 CA Primary
General Practice Dentistry 1223G0001X 36783 CA

Addresses

Primary practice location

5300 Geary Blvd
#210
San Francisco, CA 94121

Mailing address

5300 Geary Blvd.
#210
San Francisco, CA 94121
Phone (415) 668-8862

Other identifiers 1

IdentifierTypeStateIssuer
512386OtherCAMEDI-CAL PROVIDER

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
I20160119000810 CA Order and Referring Only - DentistPractitioner - Dentist 5496058877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36783CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1700864774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 GEARY BLVD.",
            "address_2": "#210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94121",
            "telephone_number": "415-668-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 GEARY BLVD",
            "address_2": "#210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94121",
            "telephone_number": "415-668-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "STANFORD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36783",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER",
            "identifier": "512386",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.