MEDICARE: DR. RATHANA LIM MD, DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	56788	CA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	6089	LA

General Provider Information

NPI Number	:	1427219245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RATHANA LIM MD, DDS

Provider Business Mailing Address
First Line	:	230 20TH ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-1236
Country	:	US
Telephone Number	:	213-422-0928
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 FLORIDA AVE
Second Line	:	5TH FLOOR - DEPT OF ORAL & MAXILLOFACIAL SURGERY
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-2715
Country	:	US
Telephone Number	:	504-941-8216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	03/07/2023

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