Provider Demographics
NPI:1427280213
Name:LI, WEI (DMD)
Entity type:Individual
Prefix:DR
First Name:WEI
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11908 DARNESTOWN RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2295
Mailing Address - Country:US
Mailing Address - Phone:301-947-5300
Mailing Address - Fax:
Practice Address - Street 1:11908 DARNESTOWN RD
Practice Address - Street 2:SUITE E
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2295
Practice Address - Country:US
Practice Address - Phone:301-947-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16077122300000X
PADS0379221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes122300000XDental ProvidersDentist