Provider Demographics
NPI:1316315617
Name:LIN, KATHERINE (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Mailing Address - Street 2:BLDG 9, 2ND FLOOR, RM 2670, 8930 BROWN DRIVE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5329
Mailing Address - Country:US
Mailing Address - Phone:301-400-2341
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Practice Address - Street 2:BLDG 9, 2ND FLOOR, RM 2670, 8930 BROWN DRIVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5329
Practice Address - Country:US
Practice Address - Phone:301-400-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15977122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist