Provider Demographics
NPI:1790934354
Name:DR. JANET C. LIM , D.M.D
Entity Type:Organization
Organization Name:DR. JANET C. LIM , D.M.D
Other - Org Name:DR. JANET C. LIM-OMBAO, D.M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:650-588-3080
Mailing Address - Street 1:112 PARK PL
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1235
Mailing Address - Country:US
Mailing Address - Phone:650-588-3080
Mailing Address - Fax:650-588-3081
Practice Address - Street 1:112 PARK PLACE
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1235
Practice Address - Country:US
Practice Address - Phone:650-588-3080
Practice Address - Fax:650-588-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44972122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty