Provider Demographics
NPI:1184179756
Name:LIN, KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
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 1:3030 MONET DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1446
Mailing Address - Country:US
Mailing Address - Phone:832-681-1608
Mailing Address - Fax:
Practice Address - Street 1:9888 BELLAIRE BLVD
Practice Address - Street 2:STE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3429
Practice Address - Country:US
Practice Address - Phone:832-681-1608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist