Active NPI
Benjamin Lin
- Dentist
- Arlington, VA
National Provider Identifier
1285251900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401417339
- Practice address
- 3565 Lee Hwy # S3B
Arlington, VA 22207-3756 - Phone
- (571) 447-5577
- NPI assigned
- Jun 29, 2020
- Last updated
- Jul 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 0401417339 | VA | Primary |
Addresses
Primary practice location
3565 Lee Hwy # S3B
Arlington, VA 22207-3756
Mailing address
6650 Bryson Alexander Way Apt 206
Falls Church, VA 22042-2288
Other practice location 1
1800 Orleans St
Baltimore, MD 21287-0010
Phone (248) 722-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200714000703 | MD | Order and Referring Only - Dentist | 9739502485 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401417339 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moon Mollov Klein DDS PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1285251900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6650 BRYSON ALEXANDER WAY APT 206",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220422288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3565 LEE HWY # S3B",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222073756",
"telephone_number": "571-447-5577"
}
],
"practiceLocations": [
{
"address_1": "1800 Orleans St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870010",
"country_code": "US",
"telephone_number": "248-722-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIN",
"first_name": "BENJAMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-29",
"last_updated": "2021-07-15",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401417339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.