Provider Demographics
NPI:1447414917
Name:LIM, JANET C (DMD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:C
Last Name:LIM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:C
Other - Last Name:LIM-OMBAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:112 PARK PL
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1235
Mailing Address - Country:US
Mailing Address - Phone:650-588-3080
Mailing Address - Fax:650-588-3081
Practice Address - Street 1:112 PARK PL
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1235
Practice Address - Country:US
Practice Address - Phone:650-588-3080
Practice Address - Fax:650-588-3081
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA449721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice