| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACK LAM | 1487128518 | 2024-08-11 |
Jack Lam is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1487128518. Registration indicates Jack Lam is a provider of access to dentists-general services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist, ) (Dental, ) (Dentist, Dental Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:N |
| Entity Type | Individual |
| Provider Name | Jack Lam DMD |
| Practice Office Address | 53 ELIZABETH ST # 2F NEW YORK, NY US |
| Practice Office Telephone | 2122198182 |
| Mailing Address | 53 ELIZABETH ST FL 2 NEW YORK, NY 100134617 US |
| Business Telephone | 2122198182 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 125 Walker St Fl 2 | New York, NY 100134135 | 2122269339 / 2122262289 |
| Code | Practice | License No State |
|---|---|---|
| 122300000X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist Dental Dentist Dental Providers | 060534
NY |
| 060534 | OTHER | NY | LICENSE |