Provider Demographics
NPI:1730694910
Name:RUIXIANG LI QIN DMD INC
Entity type:Organization
Organization Name:RUIXIANG LI QIN DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUIXIANG
Authorized Official - Middle Name:LI
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-688-0086
Mailing Address - Street 1:933 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4809
Mailing Address - Country:US
Mailing Address - Phone:510-839-1986
Mailing Address - Fax:510-839-1985
Practice Address - Street 1:933 JACKSON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4809
Practice Address - Country:US
Practice Address - Phone:510-839-1986
Practice Address - Fax:510-839-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-09
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental