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General NPI Number Information
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NPI Number | 1467841163
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Entity Type | Individual
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Provider Name | TIKI LAM DDS
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Gender | Female
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 7334 GIRARD AVE STE 102
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-459-0691
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Fax |
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Provider Business Mailing Address
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Address Line | 7334 GIRARD AVE STE 102
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City | LA JOLLA
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State | CA
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Zip | 92037-5141
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Country | US
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Telephone | 858-459-0691
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Fax | 858-459-7346
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901021449
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS102283
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License Number State | CA
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