Provider Demographics
NPI:1528384997
Name:LO, DANNY LI-WEI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:LI-WEI
Last Name:LO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15342 76TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3142
Mailing Address - Country:US
Mailing Address - Phone:917-312-4600
Mailing Address - Fax:718-380-7816
Practice Address - Street 1:15342 76TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3142
Practice Address - Country:US
Practice Address - Phone:917-312-4600
Practice Address - Fax:718-380-7816
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047934-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist