VIDA WING LONG LAM D.D.S
Complete NPI Record 1396274569
Student in an Organized Health Care Education/Training Program in Staten Island, NY

NPI Status: Active since June 09, 2017

Contact Information

475 SEAVIEW AVENUE
DEPARTMENT OF DENTISTRY
STATEN ISLAND, NY
ZIP 10305
Phone: (718) 226-9080

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Complete NPI Dataset

This directory record outlines the complete schema field listings, logged data values, and structural definitions for VIDA WING LONG LAM D.D.S (NPI: 1396274569), practicing as a certified student in an organized health care education/training program specialist with primary operations located in Staten Island, NY. The dataset listed below details the current information logged inside the National Plan and Provider Enumeration System (NPPES) registry database for this specific individual assignment. Please use the integrated filtering tools directly below to separate properties by functional clinical categories, perform live keyword lookups, or jump immediately to a single tracking attribute line item.

Registry File Document Utilities
NPI: 1396274569
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal Name: LAM
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: VIDA WING LONG
The first name of the provider, if the provider is an individual.
Provider Credential Text: D.D.S
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 475 SEAVIEW AVENUE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address: DEPARTMENT OF DENTISTRY
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City Name: STATEN ISLAND
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 10305
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider First Line Business Practice Location Address: 475 SEAVIEW AVENUE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: DEPARTMENT OF DENTISTRY
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: STATEN ISLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NY
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 10305
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7182269080
The telephone number associated with the location address of the provider being identified.
NPI Deactivation Date: 1/11/2018
The date that the provider's NPI was deactivated in the NPS.
NPI Reactivation Date: 1/24/2018
The date that the provider's NPI was reactivated in the NPS.
Provider Gender Code: F
The code designating the provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 390200000X
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Sole Proprietor: N
Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
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