Provider Demographics
NPI:1750877569
Name:LIN, WEIYE (DMD)
Entity type:Individual
Prefix:DR
First Name:WEIYE
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8129 LAKE BALLINGER WAY UNIT 101
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-9182
Mailing Address - Country:US
Mailing Address - Phone:425-361-1343
Mailing Address - Fax:
Practice Address - Street 1:8129 LAKE BALLINGER WAY UNIT 101
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-9182
Practice Address - Country:US
Practice Address - Phone:425-361-1343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-04
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340731223G0001X
NMDD50431223G0001X
NV73091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34073OtherTEXAS LICENSE
NMDD5043OtherNEW MEXICO LICENSE