Provider Demographics
NPI:1356086789
Name:WINSTON LO DDS, PLLC
Entity Type:Organization
Organization Name:WINSTON LO DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:CHENG
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-291-4374
Mailing Address - Street 1:14742 SE 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5056
Mailing Address - Country:US
Mailing Address - Phone:206-291-4374
Mailing Address - Fax:
Practice Address - Street 1:4935 LAKEMONT BLVD SE STE B3
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-7800
Practice Address - Country:US
Practice Address - Phone:425-746-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty