Provider Demographics
NPI:1730303850
Name:LEMINH, LOAN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LOAN
Middle Name:
Last Name:LEMINH
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 1:11076 SUNSET RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4868
Mailing Address - Country:US
Mailing Address - Phone:561-364-2971
Mailing Address - Fax:
Practice Address - Street 1:4911 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-2926
Practice Address - Country:US
Practice Address - Phone:561-582-5273
Practice Address - Fax:561-582-5255
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL076624101Medicaid