Provider Demographics
NPI:1730420621
Name:LWIN, THIT THIT (DDS)
Entity type:Individual
Prefix:
First Name:THIT
Middle Name:THIT
Last Name:LWIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6503 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1936
Mailing Address - Country:US
Mailing Address - Phone:626-286-2156
Mailing Address - Fax:626-286-2598
Practice Address - Street 1:6503 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1936
Practice Address - Country:US
Practice Address - Phone:626-286-2156
Practice Address - Fax:626-286-2598
Is Sole Proprietor?:No
Enumeration Date:2013-03-03
Last Update Date:2013-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46877122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist