Provider Demographics
NPI:1780094045
Name:LI, MICHELLE YUAN LING (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE YUAN LING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SECOND HOSPITAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:SINGAPORE
Mailing Address - State:SINGAPORE
Mailing Address - Zip Code:168937
Mailing Address - Country:SG
Mailing Address - Phone:656-435-3263
Mailing Address - Fax:656-438-3848
Practice Address - Street 1:3 SECOND HOSPITAL AVENUE
Practice Address - Street 2:
Practice Address - City:SINGAPORE
Practice Address - State:SINGAPORE
Practice Address - Zip Code:168937
Practice Address - Country:SG
Practice Address - Phone:656-435-3263
Practice Address - Fax:656-438-3848
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL019030601122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program