Provider Demographics
NPI:1194857466
Name:SHI-LIN NIU D M D INC
Entity Type:Organization
Organization Name:SHI-LIN NIU D M D INC
Other - Org Name:SHI-LIN NIU DMD., MS.,INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHI-LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-309-0066
Mailing Address - Street 1:701 S SAN GABRIEL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2764
Mailing Address - Country:US
Mailing Address - Phone:626-309-0066
Mailing Address - Fax:
Practice Address - Street 1:701 S SAN GABRIEL BLVD STE C
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2764
Practice Address - Country:US
Practice Address - Phone:626-309-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty