Individual provider Active NPI

Carl Lau, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1750663266
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24820 Issued in CA
Practice address
1200 Wilshire Blvd
Suite 205
Los Angeles, CA 90017-1908
Phone
(818) 897-5512
NPI assigned
Sep 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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 24820 CA Primary

Addresses

Primary practice location

1200 Wilshire Blvd
Suite 205
Los Angeles, CA 90017-1908

Mailing address

PO Box 4572
Sunland, CA 91041-4572
Phone (818) 897-5512

Other identifiers 1

IdentifierTypeStateIssuer
3390354OtherCAUSAA MEMBERSHIP

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

LicenseStateTypeSpecialty
24820CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1750663266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4572",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910414572",
            "telephone_number": "818-897-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "address_2": "SUITE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "818-897-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-12",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USAA MEMBERSHIP",
            "identifier": "3390354",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.