Provider Demographics
NPI:1497334395
Name:WENLI LOO DDS INC
Entity Type:Organization
Organization Name:WENLI LOO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WENLI
Authorized Official - Middle Name:
Authorized Official - Last Name:LOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-923-5685
Mailing Address - Street 1:2791 RANDALL LOOP STE 2640
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4294
Mailing Address - Country:US
Mailing Address - Phone:917-923-5685
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 2640
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4211
Practice Address - Country:US
Practice Address - Phone:415-477-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty