Provider Demographics
NPI:1851758353
Name:MELISA LIN, DMD, PLLC
Entity Type:Organization
Organization Name:MELISA LIN, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-454-5690
Mailing Address - Street 1:1800 116TH AVE NE
Mailing Address - Street 2:SUITE #105
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3043
Mailing Address - Country:US
Mailing Address - Phone:425-454-5690
Mailing Address - Fax:
Practice Address - Street 1:1800 116TH AVE NE
Practice Address - Street 2:SUITE #105
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3043
Practice Address - Country:US
Practice Address - Phone:425-454-5690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty