Provider Demographics
NPI:1598992356
Name:WAYNE S LYN, DMD, INC
Entity Type:Organization
Organization Name:WAYNE S LYN, DMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LYN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:858-551-2400
Mailing Address - Street 1:7855 FAY AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4265
Mailing Address - Country:US
Mailing Address - Phone:858-551-2400
Mailing Address - Fax:858-551-1072
Practice Address - Street 1:7855 FAY AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4265
Practice Address - Country:US
Practice Address - Phone:858-551-2400
Practice Address - Fax:858-551-1072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539231223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty