Provider Demographics
NPI:1164440509
Name:LAM, ANDY DAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:DAO
Last Name:LAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NORTHWEST HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5837
Mailing Address - Country:US
Mailing Address - Phone:972-926-4800
Mailing Address - Fax:972-926-4880
Practice Address - Street 1:1309 NORTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5837
Practice Address - Country:US
Practice Address - Phone:972-926-4800
Practice Address - Fax:972-926-4880
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25921122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist