Provider Demographics
NPI:1215623277
Name:WANHO LEW DDS PLLC
Entity type:Organization
Organization Name:WANHO LEW DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WANHO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-536-5088
Mailing Address - Street 1:510 E 80TH ST OFC 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0719
Mailing Address - Country:US
Mailing Address - Phone:646-536-5088
Mailing Address - Fax:646-536-5077
Practice Address - Street 1:510 E 80TH ST OFC 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0719
Practice Address - Country:US
Practice Address - Phone:646-536-5088
Practice Address - Fax:646-536-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental