NPIMap

Individual provider Active NPI

Evelyn Jin, DMD

  • Dentist
  • Everett, MA
National Provider Identifier
1295393528
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1858288 Issued in MA
Practice address
285 Main St
Everett, MA 02149-5719
Phone
(617) 207-0705
NPI assigned
Jun 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858288 MA Primary

Addresses

Primary practice location

285 Main St
Everett, MA 02149-5719

Mailing address

100 Rivers Edge Dr Unit 429
Medford, MA 02155-5476
Phone (617) 608-8318

Other practice location 1

3033 Washington St
Roxbury, MA 02119-1227
Phone (617) 541-2200

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

State licenses

LicenseStateTypeSpecialty
DN1858288MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Dreams, LLC 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1295393528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVERS EDGE DR UNIT 429",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555476",
            "telephone_number": "617-608-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MAIN ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495719",
            "telephone_number": "617-207-0705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3033 Washington St",
            "address_purpose": "LOCATION",
            "city": "Roxbury",
            "state": "MA",
            "postal_code": "021191227",
            "country_code": "US",
            "telephone_number": "617-541-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIN",
        "first_name": "EVELYN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-01",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.