Provider Demographics
NPI:1619178746
Name:LIN, DANIEL LIWEI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LIWEI
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:LI-WEI
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:942 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6743
Mailing Address - Country:US
Mailing Address - Phone:917-570-5451
Mailing Address - Fax:
Practice Address - Street 1:500 S MURPHY AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6116
Practice Address - Country:US
Practice Address - Phone:917-570-5451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051035122300000X
CA1043291223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist