Provider Demographics
NPI:1851433205
Name:LIN, JAMES S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2219 SOUTH HACIENDA BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745
Mailing Address - Country:US
Mailing Address - Phone:626-330-2022
Mailing Address - Fax:626-330-2022
Practice Address - Street 1:2219 SOUTH HACIENDA BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745
Practice Address - Country:US
Practice Address - Phone:626-330-2022
Practice Address - Fax:626-330-2022
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADP034149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist