Provider Demographics
NPI:1902132244
Name:LAM, DAVID KING (MD, DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KING
Last Name:LAM
Suffix:
Gender:M
Credentials:MD, DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 FIFTH STREET
Mailing Address - Street 2:DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1208
Mailing Address - Country:US
Mailing Address - Phone:631-416-0363
Mailing Address - Fax:
Practice Address - Street 1:155 FIFTH STREET
Practice Address - Street 2:DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1208
Practice Address - Country:US
Practice Address - Phone:631-416-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0593541223S0112X, 174400000X, 204E00000X
CA1071931223S0112X, 174400000X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No174400000XOther Service ProvidersSpecialist