Provider Demographics
NPI:1952854218
Name:LI, MIN-YIN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:MIN-YIN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3043 OLD DENTON RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5003
Mailing Address - Country:US
Mailing Address - Phone:972-323-5108
Mailing Address - Fax:
Practice Address - Street 1:1601 N ELM ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3026
Practice Address - Country:US
Practice Address - Phone:940-566-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX369761223P0300X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics