Individual provider Active NPI

Casey Kien Chung Lau, DDS

  • General Practice Dentistry
  • Northridge, CA
National Provider Identifier
1891985917
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50074 Issued in CA
Practice address
19331 Business Center Drive.
Suite 101
Northridge, CA 91324
Phone
(818) 886-3500
Fax
(818) 886-1733
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 50074 CA Primary

Addresses

Primary practice location

19331 Business Center Drive.
Suite 101
Northridge, CA 91324

Mailing address

19331 Business Center Drive
Suite 101
Northridge, CA 91324
Phone (818) 886-3500

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
I20241021003865 CA Practitioner - DentistPractitioner - Oral Surgery 1254521701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50074CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Valley Dental Care-Northridge General Practice CurrentSince Aug 23, 2024 Accepting new patients

Locations

8815 Reseda Blvd
Northridge, CA 91324
Phone (818) 886-3500

19331 Business Center Dr
Ste 101
Northridge, CA 91324
Phone (818) 886-3500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1891985917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19331 BUSINESS CENTER DRIVE",
            "address_2": "SUITE 101",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91324",
            "telephone_number": "818-886-3500",
            "fax_number": "818-886-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19331 BUSINESS CENTER DRIVE.",
            "address_2": "SUITE 101",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91324",
            "telephone_number": "818-886-3500",
            "fax_number": "818-886-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "CASEY",
        "middle_name": "KIEN CHUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.