Provider Demographics
NPI:1285899435
Name:LIN, DONGMING (DDS, MS, MPH)
Entity type:Individual
Prefix:
First Name:DONGMING
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS, MS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22400 WESTHEIMER PKWY
Mailing Address - Street 2:APT. 709
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8304
Mailing Address - Country:US
Mailing Address - Phone:415-254-5872
Mailing Address - Fax:
Practice Address - Street 1:22400 WESTHEIMER PKWY
Practice Address - Street 2:APT. 709
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8304
Practice Address - Country:US
Practice Address - Phone:415-254-5872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist