Active NPI
Tian Jin, DDS
- Dentist
- Pasadena, CA
National Provider Identifier
1003286519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64980
- Practice address
- 788 E Walnut St
Pasadena, CA 91101-1638 - Phone
- (626) 500-1599
- NPI assigned
- Sep 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64980 | CA | Primary |
Addresses
Primary practice location
788 E Walnut St
Pasadena, CA 91101-1638
Mailing address
788 E Walnut St
Pasadena, CA 91101-1638
Phone (626) 500-1599
Other practice location 1
2216 Foothill Blvd
LA Verne, CA 91750-2944
Phone (909) 480-4766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565568000000",
"number": "1003286519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "788 E WALNUT ST",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011638",
"telephone_number": "626-500-1599",
"fax_number": "626-500-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "788 E WALNUT ST",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011638",
"telephone_number": "626-500-1599"
}
],
"practiceLocations": [
{
"address_1": "2216 Foothill Blvd",
"address_purpose": "LOCATION",
"city": "LA Verne",
"state": "CA",
"postal_code": "917502944",
"country_code": "US",
"telephone_number": "909-480-4766",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JIN",
"first_name": "TIAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-28",
"last_updated": "2019-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.