Provider Demographics
NPI:1518441237
Name:LI QIN DENTAL PRACTICE INC
Entity Type:Organization
Organization Name:LI QIN DENTAL PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUIXIANG
Authorized Official - Middle Name:LI
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-688-0087
Mailing Address - Street 1:1698 SCENICVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5333
Mailing Address - Country:US
Mailing Address - Phone:520-241-3765
Mailing Address - Fax:
Practice Address - Street 1:320 8TH ST STE 2D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4261
Practice Address - Country:US
Practice Address - Phone:510-688-0087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental