Provider Demographics
NPI:1003012329
Name:LINH N VAN DDS INC
Entity Type:Organization
Organization Name:LINH N VAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:N
Authorized Official - Last Name:VAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-902-0226
Mailing Address - Street 1:1667 DOMINICAN WAY
Mailing Address - Street 2:SUITE 232
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1518
Mailing Address - Country:US
Mailing Address - Phone:831-476-5512
Mailing Address - Fax:
Practice Address - Street 1:1667 DOMINICAN WAY
Practice Address - Street 2:SUITE 232
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1518
Practice Address - Country:US
Practice Address - Phone:831-476-5512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50389261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental