Healthcare Provider Details

I. General information

NPI: 1982384475
Provider Name (Legal Business Name): DANNY LIM D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date: 02/22/2024
Reactivation Date: 09/23/2026

III. Provider practice location address

35 W 31ST ST FL 2
NEW YORK NY
10001-4561
US

IV. Provider business mailing address

345 E 24TH STREET
NEW YORK NY
10010
US

V. Phone/Fax

Practice location:
  • Phone: 212-594-9197
  • Fax:
Mailing address:
  • Phone: 212-998-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03139900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number065747
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number065747
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: