PETERSON LIM D.D.S.
NPI 1578964110
Dentist - General Practice in Milpitas, CA
About Peterson Lim D.d.s. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PETERSON LIM D.D.S. (NPI 1578964110) is an individual general practice provider in Milpitas, California, licensed in California (63828) and active in the NPI registry since September 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peterson Lim D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Peterson Lim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Leandro, CA 94577
- Reassigned Medicare billing, California enrollment
- 42 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95035 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Peterson Lim's NPI number?
The NPI number for Peterson Lim is 1578964110. It was assigned to this individual provider in the NPPES registry on September 15, 2014.
Where is Peterson Lim located?
Peterson Lim practices at 371 Jacklin Rd, Milpitas, CA 95035. The listed phone number is (408) 263-2252.
What is Peterson Lim's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Peterson Lim enrolled in Medicare?
Yes. Peterson Lim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Peterson Lim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Peterson Lim reassigns Medicare benefits to The Davis Street Community Center Incorporated (San Leandro, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Peterson Lim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Peterson Lim accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Renaissance Dental list Peterson Lim 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 Peterson Lim was last updated on September 15, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Peterson Lim, D.D.S. · NPI 1578964110
General Practice provider in Milpitas, California. Individual provider, active in the CMS NPPES registry since September 15, 2014.
## Identity
- **NPI:** 1578964110 (Entity type: Individual)
- **Enumerated:** September 15, 2014
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 63828 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 371 JACKLIN RD, Milpitas, CA 95035-3225
- **Phone:** (408) 263-2252
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** The Davis Street Community Center Incorporated (NPI 1215358924, San Leandro, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** September 15, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1578964110) · Data from the CMS NPPES public registry.