Provider Demographics
NPI:1184851925
Name:LAI, PEARL (DDS)
Entity Type:Individual
Prefix:
First Name:PEARL
Middle Name:
Last Name:LAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 TURNPIKE DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7041
Mailing Address - Country:US
Mailing Address - Phone:719-231-0728
Mailing Address - Fax:
Practice Address - Street 1:8501 TURNPIKE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7041
Practice Address - Country:US
Practice Address - Phone:719-231-0728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99361223G0001X
MND12915204E00000X
COD99361223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN190001157Medicare PIN