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General NPI Number Information
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NPI Number | 1245497957
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Entity Type | Organization
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Legal Business Name | LEI YIN DDS DENTAL CORPORATION
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 1000 NEWBURY RD STE 255
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6444
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Country | US
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Telephone | 805-480-3934
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Fax | 805-480-3940
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Provider Business Mailing Address
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Address Line | 1000 NEWBURY RD STE 255
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6444
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Country | US
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Telephone | 805-480-3934
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Fax | 805-480-3940
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEI YIN
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Credential |
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Telephone | 805-480-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 50697
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License Number State | CA
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