Provider Demographics
NPI:1972836708
Name:NING, LI (DDS, MS, PHD)
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:NING
Suffix:
Gender:F
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-1162
Mailing Address - Country:US
Mailing Address - Phone:585-254-6480
Mailing Address - Fax:585-254-1092
Practice Address - Street 1:322 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1162
Practice Address - Country:US
Practice Address - Phone:585-254-6480
Practice Address - Fax:585-254-1092
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0556651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program