MEDICARE: MRS. LOAN LEMINH DDS

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	122300000X	Dentist	DN12630	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730303850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LOAN LEMINH DDS

Provider Business Mailing Address
First Line	:	11076 SUNSET RIDGE CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33473-4868
Country	:	US
Telephone Number	:	561-364-2971
Fax Number	:

Provider Business Practice Location Address
First Line	:	4911 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2926
Country	:	US
Telephone Number	:	561-582-5273
Fax Number	:	561-582-5255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	02/22/2011

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