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DR. MICHAEL LY D.M.D
NPI 1104008523
Dentist - General Practice in Pasadena, CA

Active since November 27, 2007PECOS Enrolled
255 N ROSEMEAD BLVD, PASADENA, CA 91107(626) 731-8520 Get Directions Write a Review

NPPES record last updated: August 5, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Michael Ly D.m.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL LY D.M.D (NPI 1104008523) is an individual general practice provider in Pasadena, California, licensed in California (56446) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104008523
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MICHAEL LYCredential: D.M.D
Location Address255 N ROSEMEAD BLVDPasadena, CA 91107-3102
Mailing Address455 N Los Robles AvePasadena, CA 91101-1301 · (626) 731-8520
Phone(626) 731-8520
Sole ProprietorYes
Enumeration DateNovember 27, 2007
Last NPPES UpdateAugust 5, 2008
✔ NPI 1104008523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 56446
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
255 N ROSEMEAD BLVD, Pasadena, CA 91107
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michael Ly D.m.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAHIMI DENTAL CORPORATION
Dentist (General Practice)
255 N ROSEMEAD BLVD
PASADENA, CA 91107
Los Angeles County (626) 351-0195
ARTUR AZATYAN
Dentist
255 N ROSEMEAD BLVD
PASADENA, CA 91107
Los Angeles County (818) 438-7407

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Ly's NPI number?

The NPI number for Michael Ly is 1104008523. It was assigned to this individual provider in the NPPES registry on November 27, 2007.

Where is Michael Ly located?

Michael Ly practices at 255 N Rosemead Blvd, Pasadena, CA 91107. The listed phone number is (626) 731-8520.

What is Michael Ly's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Michael Ly enrolled in Medicare?

Yes. Michael Ly is registered in the Medicare PECOS enrollment system.

What insurance does Michael Ly accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 2 other insurers list Michael Ly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Ly was last updated on August 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.