Provider Demographics
NPI:1962775577
Name:LIN, LAVINIA CHEN (DDS)
Entity type:Individual
Prefix:
First Name:LAVINIA
Middle Name:CHEN
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 1:2223 S MONACO PKWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5893
Mailing Address - Country:US
Mailing Address - Phone:303-639-3279
Mailing Address - Fax:303-639-8482
Practice Address - Street 1:2223 S MONACO PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5893
Practice Address - Country:US
Practice Address - Phone:303-639-3279
Practice Address - Fax:303-639-8482
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice