Provider Demographics
NPI:1588411748
Name:DANNUO LI DDS INC
Entity type:Organization
Organization Name:DANNUO LI DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NOVA
Authorized Official - Middle Name:DANNUO
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-554-5748
Mailing Address - Street 1:113 WATERWORKS WAY STE 335
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3173
Mailing Address - Country:US
Mailing Address - Phone:949-889-0006
Mailing Address - Fax:
Practice Address - Street 1:113 WATERWORKS WAY STE 335
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3173
Practice Address - Country:US
Practice Address - Phone:949-889-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-04
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty