1538209325 NPI number — HSUAN-LI LIN DDS

Table of content: HSUAN-LI LIN DDS (NPI 1538209325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538209325 NPI number — HSUAN-LI LIN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIN
Provider First Name:
HSUAN-LI
Provider Middle Name:
Provider Name Prefix Text:
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:
1538209325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
983 BELLEFLOWER PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALION
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44833-2328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-578-7721
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3646 E. MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-231-8102
Provider Business Practice Location Address Fax Number:
614-231-4801
Provider Enumeration Date:
02/08/2007

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: 1223G0001X , with the licence number:  30022429 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2672004 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9184909 . This is a "DORAL PROVIDER #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 260135218033 . This is a "CARE SOURCE PROVIDER #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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