Individual provider Active NPI

Lucille Lam, D.D.S.

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1942598552
Registry record updated Jul 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60386 Issued in CA
Practice address
8013 Laguna Blvd Ste 2
Elk Grove, CA 95758-7920
Phone
(916) 691-6020
NPI assigned
Jul 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 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 60386 CA Primary

Addresses

Primary practice location

8013 Laguna Blvd Ste 2
Elk Grove, CA 95758-7920

Mailing address

2404 24TH St Apt a
Sacramento, CA 95818-2551

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
60386CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Thaddous Archie, DDS PastSince Nov 10, 2024 Accepting new patients

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": "1310774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310774400000",
    "number": "1942598552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 24TH ST APT A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958182551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 LAGUNA BLVD STE 2",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587920",
            "telephone_number": "916-691-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "LUCILLE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-16",
        "last_updated": "2011-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.