Provider Demographics
NPI:1891315107
Name:LIN, STEVEN (DDS, MBS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS, MBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 168TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1331
Mailing Address - Country:US
Mailing Address - Phone:917-617-9815
Mailing Address - Fax:
Practice Address - Street 1:2211 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4752
Practice Address - Country:US
Practice Address - Phone:516-365-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0621311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry