Provider Demographics
NPI:1386862225
Name:LIN, JASON VEI-CHANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:VEI-CHANG
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24445 GOLDPOINT PL
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1868
Mailing Address - Country:US
Mailing Address - Phone:714-608-6669
Mailing Address - Fax:
Practice Address - Street 1:24445 GOLDPOINT PL
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1868
Practice Address - Country:US
Practice Address - Phone:714-608-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist