Healthcare Provider Details

I. General information

NPI: 1659298669
Provider Name (Legal Business Name): NORWALK DENTAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 WASHINGTON ST
NORWALK CT
06854-2704
US

IV. Provider business mailing address

9 WASHINGTON ST
NORWALK CT
06854-2704
US

V. Phone/Fax

Practice location:
  • Phone: 718-968-5350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DAVID LIN
Title or Position: DENTIST
Credential: DDS
Phone: 718-968-5350