1790761674 NPI number — DR. CHIN R LIN DDS

Table of content: DR. CHIN R LIN DDS (NPI 1790761674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790761674 NPI number — DR. CHIN R LIN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIN
Provider First Name:
CHIN
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790761674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
FLUGPLATZ ERBENHEIM BLDG 1040
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WIESBADEN
Provider Business Mailing Address State Name:
HESSEN
Provider Business Mailing Address Postal Code:
65205
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FLUGPLATZ ERBENHEIM BLDG 1040
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WIESBADEN
Provider Business Practice Location Address State Name:
HESSEN
Provider Business Practice Location Address Postal Code:
65205
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
0637194641325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  51028 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223P0221X , with the licence number: 019-023264 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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