Provider Demographics
NPI:1437272242
Name:LAI, HERRICK (DDS)
Entity Type:Individual
Prefix:
First Name:HERRICK
Middle Name:
Last Name:LAI
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 1:9317 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:64 METROPOLITAN OVAL
Practice Address - Street 2:SUITE #9
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6630
Practice Address - Country:US
Practice Address - Phone:718-892-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist