Individual provider Active NPI

Benjamin Lin

  • Dentist
  • Arlington, VA
National Provider Identifier
1285251900
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401417339 Issued in VA
Practice address
3565 Lee Hwy # S3B
Arlington, VA 22207-3756
Phone
(571) 447-5577
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200714000703 MD Order and Referring Only - DentistPractitioner - Dentist 9739502485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401417339VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Moon Mollov Klein DDS PC Dentist PastSince Jul 25, 2021 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 and National Provider Directory roles.

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

Verify at the official NPI Registry.