Provider Demographics
NPI:1255476164
Name:YIN, LEI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEI
Middle Name:
Last Name:YIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NEWBURY RD STE 255
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6444
Mailing Address - Country:US
Mailing Address - Phone:805-480-3934
Mailing Address - Fax:805-480-3940
Practice Address - Street 1:1000 NEWBURY RD STE 255
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-6444
Practice Address - Country:US
Practice Address - Phone:805-480-3934
Practice Address - Fax:805-480-3940
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice