MEDICARE: FLUSHING ADVANCED ORTHODONTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	48932	NY

General Provider Information

NPI Number	:	1295935179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLUSHING ADVANCED ORTHODONTICS

Provider Business Mailing Address
First Line	:	39-01 MAIN ST
Second Line	:	SUITE 401
City	:	FLUSHING
State	:	NY
Zip	:	11354-5483
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39-01 MAIN ST
Second Line	:	SUITE 401
City	:	FLUSHING
State	:	NY
Zip	:	11354-5483
Country	:	US
Telephone Number	:	718-353-0880
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. LIN HU
Credential	:	D.M.D
Telephone Number	:	718-353-0880

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	07/19/2007

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Directions to “FLUSHING ADVANCED ORTHODONTICS ” Practice Location

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