Provider Demographics
NPI:1851666580
Name:LAI, KA ON (DDS)
Entity Type:Individual
Prefix:
First Name:KA
Middle Name:ON
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 1:3720 N 1ST ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1717
Mailing Address - Country:US
Mailing Address - Phone:408-894-8135
Mailing Address - Fax:
Practice Address - Street 1:3720 N 1ST ST STE C
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-1717
Practice Address - Country:US
Practice Address - Phone:408-894-8135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice