NPIMap

Organization Active NPI

La Mirada Family Dental

  • Dentist
  • La Mirada, CA
National Provider Identifier
1871795245
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40648 Issued in CA
Legal business name
LA MIRADA FAMILY DENTAL
Practice address
13922 Imperial Hwy
La Mirada, CA 90638-1725
Phone
(562) 926-7025
Fax
(562) 926-9056
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gilbert Khin Lay, DDSNPI 1821103169
Title
Owner
Phone
(562) 926-7025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 40648 CA Primary

Addresses

Primary practice location

13922 Imperial Hwy
La Mirada, CA 90638-1725

Mailing address

13922 Imperial Hwy
La Mirada, CA 90638-1725
Phone (562) 926-7025

National Provider Directory

National Provider Directory
Tax ID family
La Mirada Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871795245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13922 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381725",
            "telephone_number": "562-926-7025",
            "fax_number": "562-926-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13922 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381725",
            "telephone_number": "562-926-7025",
            "fax_number": "562-926-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MIRADA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAY",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "KHIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-926-7025",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.