Provider Demographics
NPI:1487662201
Name:JOHN H. LINTAKOON, DDS, PC
Entity Type:Organization
Organization Name:JOHN H. LINTAKOON, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LINTAKOON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-306-0601
Mailing Address - Street 1:1008 MO PAC CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6866
Mailing Address - Country:US
Mailing Address - Phone:512-306-0601
Mailing Address - Fax:
Practice Address - Street 1:1008 MO PAC CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6866
Practice Address - Country:US
Practice Address - Phone:512-306-0601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty