Healthcare Provider Details

I. General information

NPI: 1295119972
Provider Name (Legal Business Name): DAVID LIM DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RALEY BLVD STE 202
CHICO CA
95928-8352
US

IV. Provider business mailing address

101 RALEY BLVD STE 202
CHICO CA
95928-8352
US

V. Phone/Fax

Practice location:
  • Phone: 530-592-4688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDDS103699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: