Provider Demographics
NPI:1801959135
Name:LIN, THOMAS CHI RUI (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHI RUI
Last Name:LIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 LEAVENWORTH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5924
Mailing Address - Country:US
Mailing Address - Phone:785-537-2551
Mailing Address - Fax:
Practice Address - Street 1:509 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5924
Practice Address - Country:US
Practice Address - Phone:785-537-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS606301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS45-4915383OtherTIN