Individual provider Active NPI

Sung-Eun Steve Lim, DMD

  • Prosthodontics
  • San Jose, CA
National Provider Identifier
1891865192
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
54927 Issued in CA
Practice address
105 N Bascom Ave
Suite 201
San Jose, CA 95128-1811
Phone
(408) 292-2848
Fax
(408) 292-5898
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 54927 CA Primary

Addresses

Primary practice location

105 N Bascom Ave
Suite 201
San Jose, CA 95128-1811

Mailing address

105 N Bascom Ave
Suite 201
San Jose, CA 95128-1811
Phone (408) 292-2848

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
54927CAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1891865192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N BASCOM AVE",
            "address_2": "SUITE 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281811",
            "telephone_number": "408-292-2848",
            "fax_number": "408-292-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N BASCOM AVE",
            "address_2": "SUITE 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281811",
            "telephone_number": "408-292-2848",
            "fax_number": "408-292-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "SUNG-EUN",
        "middle_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "54927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.