Provider Demographics
NPI:1649782889
Name:DR. SIN DMD PA
Entity type:Organization
Organization Name:DR. SIN DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONGHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:SIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:469-888-3918
Mailing Address - Street 1:306 RUSSO VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8110
Mailing Address - Country:US
Mailing Address - Phone:919-819-8099
Mailing Address - Fax:
Practice Address - Street 1:2430 S CHURCH ST STE B
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5202
Practice Address - Country:US
Practice Address - Phone:919-819-8099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty