Nathan Lai, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-5279 Issued in ID

Practice address

1000 23Rd Ave BLDG 914
Port Hueneme, CA 93043-4300

Phone

(805) 982-5584

NPI assigned

Jun 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1801465943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 23RD AVE BLDG 914",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930434300",
            "telephone_number": "805-982-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 23RD AVE BLDG 914",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930434300",
            "telephone_number": "805-982-5584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mercy Circle",
            "address_2": "Naval Hospital Camp Pendleton",
            "address_purpose": "LOCATION",
            "city": "Camp Pendleton",
            "state": "CA",
            "postal_code": "920555191",
            "country_code": "US",
            "telephone_number": "760-725-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAI",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Christian Ketelsen, IDC
• James A Kirk, MPT
• Ryan Kitchens
• Roger Howard Knight, D.C.
• L M Rivas DMD, Inc.
• Pauline Lai, PHARM.D.
• Tina Lai
• Charlotte Lamb
• Andrew Latta, DPT
• Blanca Estela Lemus

• General Practice Dentistry in Port Hueneme, CA
• Providers in Port Hueneme, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.