Provider Demographics
NPI:1598082885
Name:YUSMAN-WIRTH, LINDA (DDS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:YUSMAN-WIRTH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8729 SW 136TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-5814
Mailing Address - Country:US
Mailing Address - Phone:305-255-5550
Mailing Address - Fax:305-255-5560
Practice Address - Street 1:8729 SW 136TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-5814
Practice Address - Country:US
Practice Address - Phone:305-255-5550
Practice Address - Fax:305-255-5560
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10419122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist