Provider Demographics
NPI:1174662019
Name:LIN, STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 LAGO ST
Mailing Address - Street 2:#28
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403
Mailing Address - Country:US
Mailing Address - Phone:415-939-2399
Mailing Address - Fax:
Practice Address - Street 1:530 SHOWERS DR
Practice Address - Street 2:SUITE 3
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-917-8348
Practice Address - Fax:650-917-8349
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47634122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist