Healthcare Provider Details

I. General information

NPI: 1942682711
Provider Name (Legal Business Name): YUNQI ROSE LIN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24430 ALESSANDRO BLVD STE 104
MORENO VALLEY CA
92553-2436
US

IV. Provider business mailing address

24430 ALESSANDRO BLVD STE 104
MORENO VALLEY CA
92553-2436
US

V. Phone/Fax

Practice location:
  • Phone: 951-601-0350
  • Fax:
Mailing address:
  • Phone: 951-601-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number100139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: