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General NPI Number Information
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NPI Number | 1780671123
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Entity Type | Individual
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Provider Name | LINDA PAINTER NIEMEYER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | USS THEODORE ROOSEVELT
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City | FPO
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State | AP
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Zip | 09599-2871
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Country | US
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Telephone | 747-444-5897
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Fax |
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Provider Business Mailing Address
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Address Line | 105 WATCH HARBOR CT
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City | SUFFOLK
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State | VA
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Zip | 23435-3179
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Country | US
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Telephone | 757-353-9557
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 014528
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License Number State | MO
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