Provider Demographics
NPI:1174843049
Name:LIN, RONALD YIMAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:YIMAO
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:YI-MAO
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 PARK ROW
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1127
Mailing Address - Country:US
Mailing Address - Phone:212-385-9399
Mailing Address - Fax:
Practice Address - Street 1:180 PARK ROW
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1127
Practice Address - Country:US
Practice Address - Phone:212-385-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0556141223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program