Provider Demographics
NPI:1720036049
Name:LINDEN, FREDERICK WILLIAM III (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:LINDEN
Suffix:III
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 1:2143 N TUSTIN ST
Mailing Address - Street 2:#5
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-3709
Mailing Address - Country:US
Mailing Address - Phone:714-516-1612
Mailing Address - Fax:714-282-2272
Practice Address - Street 1:2143 N TUSTIN ST
Practice Address - Street 2:#5
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-3709
Practice Address - Country:US
Practice Address - Phone:714-516-1612
Practice Address - Fax:714-282-2272
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA241351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice