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General NPI Number Information
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NPI Number | 1174000186
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Entity Type | Individual
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Provider Name | LIN SEBAIHI DMD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 1812 N 19TH AVE
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City | MELROSE PARK
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State | IL
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Zip | 60160
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Country | US
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Telephone | 708-665-8588
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Fax |
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Provider Business Mailing Address
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Address Line | 4849 N MILWAUKEE AVE STE 403
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City | CHICAGO
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State | IL
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Zip | 60630-2169
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.031870
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License Number State | IL
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