Healthcare Provider Details

I. General information

NPI: 1467398594
Provider Name (Legal Business Name): KO CHUN MONTEIRO LAMA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 UNION ST
LYNN MA
01901-1314
US

IV. Provider business mailing address

269 UNION ST
LYNN MA
01901-1314
US

V. Phone/Fax

Practice location:
  • Phone: 781-581-9832
  • Fax: 781-581-9583
Mailing address:
  • Phone: 781-581-9832
  • Fax: 781-581-9583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDL101242
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: