Provider Demographics
NPI:1790096618
Name:MALINDA LAM-GERSHONY, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:MALINDA LAM-GERSHONY, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:LAM
Authorized Official - Last Name:GERSHONY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-503-6271
Mailing Address - Street 1:7530 164TH AVE NE STE A235
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7826
Mailing Address - Country:US
Mailing Address - Phone:425-867-1484
Mailing Address - Fax:425-895-9555
Practice Address - Street 1:7530 164TH AVE NE STE A235
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7826
Practice Address - Country:US
Practice Address - Phone:425-867-1484
Practice Address - Fax:425-895-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE9307261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental