MEDICARE: EMILY LING DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	40660	CA

General Provider Information

NPI Number	:	1659436244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMILY LING DDS

Provider Business Mailing Address
First Line	:	9197 CENTRAL AVE
Second Line	:	SUITE C
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-1616
Country	:	US
Telephone Number	:	909-398-1107
Fax Number	:	909-398-1109

Provider Business Practice Location Address
First Line	:	9197 CENTRAL AVE
Second Line	:	SUITE C
City	:	MONTCLAIR
State	:	CA
Zip	:	91763-1616
Country	:	US
Telephone Number	:	909-398-1107
Fax Number	:	909-398-1109

Authorized Official
Title or Position	:	PRESIDENT OF CORPORATION
Name	:	EMILY LING
Credential	:	DDS
Telephone Number	:	909-398-1107

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	08/22/2020

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