Provider Demographics
NPI:1275090060
Name:JIN LIN DENTISTRY PLLC
Entity Type:Organization
Organization Name:JIN LIN DENTISTRY PLLC
Other - Org Name:HURST PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:817-510-6400
Mailing Address - Street 1:712 W PIPELINE RD STE 600
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4928
Mailing Address - Country:US
Mailing Address - Phone:817-510-6400
Mailing Address - Fax:817-510-6401
Practice Address - Street 1:712 W PIPELINE RD STE 600
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4928
Practice Address - Country:US
Practice Address - Phone:817-510-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1184030793OtherNPPES